# Foster Care and Child Maltreatment Mortality Rates in the US

## TL;DR

The study found no evidence that changes in foster care entry rates are linked to changes in child maltreatment death rates in the US.

## Contribution

It provides new population-level evidence on the relationship between foster care and child maltreatment mortality.

## Key findings

- No negative association was found between foster care entry rates and child maltreatment mortality rates.
- States reported an average of 2.62 deaths per 100,000 children and 3.21 foster care entries per 1000 children in 2023.
- The study analyzed 3.4 million records and 24,108 fatalities attributed to child abuse or neglect.

## Abstract

Do state-level child mortality rates increase when foster care entry rates decrease?

This cross-sectional study of 3.4 million records of children in state-supervised foster care found no evidence of a negative association between foster care entries and child maltreatment fatalities at the population level.

Current evidence suggests that decreasing rates of foster care entry are not associated with changes in child maltreatment mortality rates.

This cross-sectional study of children in state-supervised foster care assesses deaths due to child maltreatment and whether these fatalities are associated with foster care entry rates.

Approximately 2000 children die each year of child abuse and/or neglect. Foster care is designed as a targeted intervention to reduce harm to children, but its association with child maltreatment mortality is not well understood.

To examine whether foster care entry rates are negatively associated with rates of child mortality due to child abuse and/or neglect.

This cross-sectional study assessed associations between child maltreatment mortality rates and foster care entry rates at the state level using administrative data from all US states from January 1, 2010, to December 31, 2023 (N = 700 state-years). Administrative records on all children in state-supervised foster care and all children whose death was attributed by child welfare agencies to child maltreatment were assessed.

Number of children entering foster care per 1000 child population.

Number of child fatalities due to child abuse and/or neglect per 100 000 child population.

The study analyzed 3.4 million records of children in state-supervised foster care from 2010 to 2023 and 24 108 child fatalities that states attributed to child abuse and/or neglect. In 2023, states reported a mean (SD) of 2.62 (1.85) deaths per 100 000 child population and reported a mean (SD) of 3.21 (1.75) entries into foster care per 1000 child population. No evidence was found of a negative association between state-year level foster care entry rates and state-year–level child maltreatment mortality rates (β = 0.17; 95% CI, 0.01-0.34).

In this cross-sectional study, child maltreatment mortality rates did not appear to decrease with higher foster care entry rates or increase with decreasing foster care entry rates. This evidence suggests that there is not a negative association between child maltreatment mortality rates and foster care entry rates.