Child Abuse & Neglect 41 (2015) 40–48

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Child Abuse & Neglect

Culture and context in understanding child maltreatment: Contributions of intersectionality and neighborhood-based research Yochay Nadan a,∗ , James C. Spilsbury b , Jill E. Korbin c a b c

The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel Center for Clinical Investigation, Case School of Medicine, Case Western Reserve University, Cleveland, OH, USA Department of Anthropology and, Schubert Center for Child Studies, Case Western Reserve University, Cleveland, OH, USA

a r t i c l e

i n f o

Article history: Received 1 October 2014 Received in revised form 17 October 2014 Accepted 23 October 2014 Available online 15 November 2014 Keywords: Child maltreatment Culture Context Intersectionality Neighborhood

a b s t r a c t In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). Using the 1994 review “Sociocultural Factors in Child Maltreatment” (Korbin, 1994) as a background, this article reconsiders culture and context in child maltreatment work. Since 1994, conditions promoting research and practice attention in this area include immigration-driven global increases in diverse, multicultural societies where different beliefs and practices meet (and clash); expanding purview of the human rights discourse to children; and the disproportionate and disparate representation of cultural, ethnic, and racial groups in child-welfare systems. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. To help address these questions, we propose two approaches for future maltreatment research: intersectionality – the simultaneous examination of multiple identities (such as gender, race, and socioeconomic status) – as a framework for understanding the complexity of cultural factors; and neighborhood-based research as a means for understanding the context of child maltreatment from the perspective of an ecological framework. © 2014 Elsevier Ltd. All rights reserved.

Introduction In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). As part of a 20 year retrospective, this article revisits the 1994 review “Sociocultural Factors in Child Maltreatment” (Korbin, 1994) as a background for reconsidering culture and context in child maltreatment. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. In this article, we briefly summarize the 1994 paper and consider work in the intervening years on culture and context in child maltreatment. We also consider intersectionality as a framework for understanding the complexity of

∗ Corresponding author at: The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mt. Scopus, Jerusalem 91905, Israel. http://dx.doi.org/10.1016/j.chiabu.2014.10.021 0145-2134/© 2014 Elsevier Ltd. All rights reserved.

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cultural factors and neighborhood-based research as a means for understanding the context of child maltreatment from an ecological framework. The focus of the 1994 chapter “Sociocultural Factors in Child Maltreatment” was the relationship of culture and child maltreatment. In that chapter, Korbin emphasized culturally informed and competent definitions that centered on distinguishing among three definitional levels: (a) cultural differences, (b) violation of cultural norms, and (c) societal-level maltreatment. Korbin also pointed out that cultural differences have sometimes been difficult to determine because use of broad “racial” or geographic-origin categories mask heterogeneity among populations (for example, grouping Mexicans, Guatemalans, and Brazilians under the label of Hispanic/Latino; grouping Chinese, Thai, Japanese, and Hawaiians under the label of Asian/Pacific Islander). Fontes (2005) has since termed this practice ethnic lumping. Korbin’s recommendations urged culturally informed and culturally competent approaches and flexibility in considering the role of culture, specifically the need to “unpack” culture by identifying the specific cultural factors that increase or decrease the risk for maltreatment. She also urged attention to both across and within-cultural variability. Neighborhood-based approaches also were identified in the 1994 chapter as a promising approach in child maltreatment work both to better understand the etiology of child maltreatment and to deliver services at a more local level. Culture and Child Maltreatment Initial efforts to understand culture and child maltreatment emphasized cultural variability in what was defined as child maltreatment as well as aspects of the cultural setting and culturally based child care practices and beliefs that would explain why child abuse was more or less likely to occur in different cultures (e.g., Korbin, 1981). A positive outcome of this approach was to promote a more pluralistic perspective, avoiding ethnocentrism with a goal of developing culturally informed or culturally competent prevention and intervention programs (e.g., Fontes, 2005; Korbin & Spilsbury, 1999). Since the 1994 review, three basic and interrelated trends have contributed to continued interest in the relationship of culture and child maltreatment. First, rapidly and dramatically changing demographic trends have brought populations with differing cultural traditions and practices into contact with one another. Changing global demographics and the resulting contact among diverse populations has drawn attention to cultural conflict in many domains, including issues of child maltreatment. The world has become more diverse, with waves of immigration changing the cultural and ethnic texture of major regions of the world. The number of international migrants increased from 154 million in 1990 to a record high of 232 million in 2013 (International Migration Report, 2013). Approximately 15 per cent of international migrants (35 million) are under 20 years of age (Trends in International Migrant Stock, 2013). Dynamic, diverse, and complex multicultural societies have become a reality around the world, bringing with them potential for cultural misunderstandings and conflicts. It has become critical for child protection work to develop strategies for addressing these conflicts in the best interests of children. Second, human rights attention has been directed toward children. International conventions, notably the United Nations Convention on the Rights of the Child (UNCRC), have sought to establish universal criteria for child well-being and protection to which all nations and cultures are expected to adhere. However, the assumption of a universal childhood does not necessarily reflect the wide array of cultures and circumstances in which children live, rendering the establishment of such criteria challenging. Creation of standards to promote well-being and freedom from maltreatment applicable to all children requires a firm understanding of culture and context. Third, disproportionate and disparate representation of cultural, ethnic, and racial groupings in child welfare, primarily in Western, industrialized nations, has stimulated concerns about how best to serve diverse populations in child welfare systems. We will return to this theme in more depth later in this article. The literature on child maltreatment has seen increased attention to group differences subsumed under the terms culture, ethnicity and race. Miller and Cross (2006) analyzed articles published between 1995 and 2002 in three of the field’s leading journals (Child Abuse & Neglect, Child Maltreatment, and Journal of Child Sexual Abuse). The percentage of articles reporting ethnic composition of the sample increased from 50% between 1995 and 1998 to 59% between 1999 and 2002, and articles using ethnicity in analyses increased from 15% between 1995 and 1998 to 24% between 1999 and 2002. In addition, a growing international literature points to child maltreatment as a global phenomenon, occurring across a wide range of cultures. For example, the International Society for Prevention of Child Abuse and Neglect (ISPCAN) publishes World Perspectives, to coincide with its biannual meetings and to summarize approaches to child maltreatment across a wide range of countries. The literature on child maltreatment also has sought to identify differences in incidence and prevalence across international and cultural boundaries. A meta-analysis combining prevalence figures of childhood sexual abuse reported in 217 publications found that the lowest rates for both girls (113/1,000) and boys (41/1,000) were in Asia, and highest rates for girls were in Australia (215/1,000) and for boys in Africa (193/1,000) (Stoltenborgh, van IJzendoorn, Euser, & BakermansKranenburg, 2011). Other studies have compared child maltreatment rates between countries, suggesting that differences may be explained by cultural factors (e.g., Finkelhor, Ji, Mikton, & Dunne, 2013; Sebre et al., 2004). Differences regarding the prevalence of child maltreatment between ethnic, cultural, or racial groups within predominantly Eurocentric countries have been the focus of numerous studies (e.g., Amodeo, Griffin, Fassler, Clay, & Ellis, 2006; Fanslow, Robinson, Crengle, & Perese, 2007; Hawkins et al., 2010; Warner, Alegria, & Canino, 2012). In the United States, for example, the National Longitudinal Study of Adolescent Health estimated the prevalence of self-reported child maltreatment and examined its relationship to sociodemographic factors, including racial/ethnic group membership. The findings yielded significant relationships between selected racial/ethnic groups and each type of maltreatment. However, most of these associations were weakened when

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analyses were adjusted for the effects of other sociodemographic and socioeconomic risk factors including family income, parental education, and immigration status (Hussey, Chang, & Kotch, 2006). A related concern drawing attention to culture is the disproportionate representation of culturally diverse populations in child maltreatment reports and foster care placements (Fluke, Yuan, Hedderson, & Curtis, 2003; Hill, 2006; Wulczyn & Lery, 2007). The term racial disproportionality was coined as a means of capturing the overrepresentation and underrepresentation of certain racial and ethnic groups in child welfare services. Disproportionality occurs when a population is represented in child welfare reports in a different percentage than that population is represented in the general population. For example, disproportionality occurs when Group A comprises 10% of the population, but 50% of child welfare reports. Disparity refers to unequal outcomes experienced by one racial or ethnic group when compared to another racial or ethnic group’s outcomes (Dettlaff, 2014). For example, a disparity exists when 50% of investigations for possible maltreatment are substantiated in Group A but only 20% of investigations are substantiated in Group B. Disproportionality and disparity are related, as disparity potentially increases the likelihood of disproportionality. The disproportionate representation of minority children in child welfare systems has been documented in many areas around the world: for example, Indigenous groups in Australia (Tilbury, 2009), Aboriginal (First Nation) in Canada (Trocmé, Knoke, & Blackstock, 2004), Black and minority ethnic children in England (Owen & Statham, 2009), and immigrants in the Netherlands (Euser, van Ijzendoorn, Prinzie, & Bakermans-Kranenburg, 2011). In the United States, Black children represented 26% of children in foster care in 2012 (U.S. Department of Health & Human Services, 2013), whereas they represented only 15% of children in the general population (U.S. Census Bureau, 2012). Life table analyses offer the possibility of exploring disproportionality across multiple years of children’s lives. One such analysis in a metropolitan area of Ohio showed that by 10 years of age, 33.4% of African American children (compared with 11.8% of White children) had a substantiated or indicated report of child maltreatment (Sabol, Coulton, & Polousky, 2004). Such life table analyses can be applied to advocate for greater attention to disproportionality and disparity and to foster policy and practice reform (Crampton & Coulton, 2008). Disparities can occur at multiple decision-making points in the child welfare system, including the initial report (Fluke et al., 2003), acceptance for investigation (Sinha, Trocmé, Fallon, & MacLaurin, 2013), substantiation (Ards, Myers, Malkis Erin, & Zhou, 2003), placement into out-of-home care (Rivaux et al., 2008), and exits from care (Lu et al., 2004). Racial and ethnic disproportionality and disparity are complex phenomena. Fluke, Harden, Jenkins, and Ruehrdanz (2010) summarized four sometimes overlapping explanations of racial disproportionality and disparities in child welfare. First, disproportionality and disparity may reflect the disproportionate number of children and families of color living in poverty given poverty’s association with higher rates of maltreatment. Given this relationship between poverty and child maltreatment, some (e.g., Bartholet, 2009) argue that disproportionate removal of children of color reflects accurate assessments of child maltreatment risk for children in families of color. Second, the disproportionate representation of minority children may also result from racial bias and discrimination (e.g., Roberts, 2002). This may be present at the individual level (child welfare staff; community and mandated reporters) as well as at the agency level (institutional racism that may result from child welfare agencies’ policies and practices) (Barn, 2007). Rivaux et al. (2008) suggested that racial bias in decision-making is an important factor in contributing to racial disparities. Using data from the Texas child welfare system, they suggested the presence of race-based thresholds for removals and provision of services. Even though Black families were assessed as having lower risk of future abuse/neglect, Black children were removed at a lower risk threshold than were White children. One explanation might be that child welfare agency staff perceived any deviation from the supposed norm not only as different but also as pathological (Barn, 2007). This explanation involves what has been referred to as a deficiency approach (Park, 2005), in which minority status itself is used as a marker of risk and maltreatment. Third, child welfare systems may contribute to racial disproportionality and disparity through inequitable distribution of resources and services to families of color thereby increasing risks of maltreatment (Courtney, Barth, Berrick, & Brooks, 1996). Finally, Fluke et al. (2010) refer to geographic area based research that has identified relationships between neighborhood and community contextual factors and child maltreatment rates (e.g., Coulton, Korbin, Su, & Chow, 1995; Coulton, Korbin, & Su, 1999). This research suggests that there are multiple pathways by which neighborhood conditions impact child maltreatment behaviors and reports (Coulton, Crampton, Irwin, Spilsbury, & Korbin, 2007). In all of these potential explanations, the overrepresentation of children of color has drawn attention to questions of how culture and context influence maltreatment. Research in child maltreatment has consistently recognized the complexity of child maltreatment, and two major reviews of existing literature (National Research Council, 1993; Petersen, Joseph, & Feit, 2014) have addressed the potential impact of culture and context. However, the precise pathways and mechanisms by which culture and context influence the definition, etiology, prevention, and treatment of child maltreatment have remained somewhat elusive. Perhaps this gap in understanding can be partially attributed to the historical tendency of child maltreatment research to place less attention on the effects of culture and contextual factors and more attention on individually based explanations. Further, individually based explanations have focused largely on characteristics of abusive parents ranging from psychological to socioeconomic factors. In the next two sections of this paper, we suggest two lines of inquiry that have potential for contributing to our understanding of how culture and context influence child maltreatment. First, we suggest that the theoretical frame of intersectionality can assist in understanding how culture at the individual level (often used synonymously with race or ethnicity) simultaneously influences and is influenced by other individual characteristics, such as gender or socioeconomic status. This simultaneous interplay of characteristics may explain in part why cultural membership does not stand up as a

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Fig. 1. Intersectionality theory.

single-variable explanation for child maltreatment. Blending micro and macro levels of analysis, intersectionality also can assist in understanding how individual factors such as culture, race, or ethnicity are influenced by larger societal factors. In particular, this concept may help to explain the pathways by which disproportionality in child maltreatment reports occur. Second, following the discussion of intersectionality, we turn our attention to neighborhood-based research. Culture expresses itself in numerous ecological contexts, from the interactions of child and parent to macro-level societal factors. Examining the context of neighborhood allows us to understand a geographically bounded context for which there are multiple sources of data and influence. We argue that using neighborhood as context can shed light on how the multiple etiological factors involved in child maltreatment come into play. Intersectionality and Child Maltreatment Work Past research has found sometimes inconsistent or even conflicting results on how categories such as race/ethnicity/culture, gender, or socioeconomic status influence child maltreatment. Intersectionality is a theoretical framework for understanding how multiple identities such as gender, race and socioeconomic status simultaneously shape human experience at the individual level through interlocking systems of bias and inequality that exist at the macro social-structural level (e.g., sexism, racism, and classism). Intersectionality was first defined by Crenshaw (1989), and was further developed by U.S. Black feminists who criticized the assumption of homogeneity of all women. They argued that Black women’s experiences were also shaped by race and class – not only by gender (Collins, 2000; Davis, 1983; McCall, 2005). Later scholars have broadened their analyses to other categories of difference such as age, mental health, disability, sexual orientation, religion, and geographic location (Murphy, Hunt, Zajicek, Norris, & Hamilton, 2009). Intersectionality theory proposes that analyses that focus on gender, race, or class independently are insufficient because these social positions are experienced simultaneously. Intersectionality-informed research is driven at its core by the pursuit of social justice (Kelly, 2009). The approach also can be implemented in qualitative, quantitative, or mixed designs. In child maltreatment work, scholars adopting an intersectionality approach would argue, for example, that assigning risk by racial categories is insufficient without considering socioeconomic conditions of poverty. We represent this expanded view in Fig. 1, which shows both (a) the simultaneous intersection of numerous identities or differences at the individual or micro level and (b) the corresponding forces generated and maintained at the macro level that shape disparities and disproportionality (Kelly, 2009). Three principles of intersectionality are relevant to our discussion on culture, context and child maltreatment. First, social and cultural groups are heterogeneous. Second, power differentials are a frequently neglected but an influential implication of social structure. Third, individuals may identify with more than one social group (Stewart & McDermott, 2004). As a theoretical approach, intersectionality can assist in understanding interrelationships across macro and micro levels (see Fig. 1). At the macro level, intersectionality can be used to understand the multiplicity of societal processes and structural sources of bias and discrimination. At the micro level, intersectionality can be used to examine how individuals experience their own intersecting identities and related biases (Syed, 2010). To achieve a more complex understanding of

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how intersecting identities such as race, ethnicity, class and gender impact the experiences of families and children, both levels should be considered simultaneously. Child maltreatment research and policy, with some exceptions of multi-level work (see Coulton et al., 2007), tend to focus on a single category of difference, for example ethnicity, socioeconomic status or gender. Less attention has been paid to intersectionality or how multiple categories are linked in their effects. Moreover, the current literature in child maltreatment largely does not address intersections of multiple interlocking identities at the micro level with multiple interlocking structural-level bias and inequality at the macro level of society. Intersectionality, then, holds the potential to explain the complexity of disparities across a multiple factors, including but not limited to race, ethnicity, culture, religion, immigration, socioeconomic status, gender, and geographic location (Bowleg, 2012). Intersectionality can encourage research to focus on complex explanations that can then contribute to efforts to alleviate disparities. It also has potential for offering a unifying language for researchers and practitioners. Cole (2009) proposed three issues for research addressing intersectionality. First, research must consider group membership that encompasses multiple categories. This question can target the known problem of ethnic lumping (Fontes, 2005) in child maltreatment – the use of large group categorizations (e.g., African-American, non-Latino White) that risks minimizing or ignoring intra-group diversity. Second, research must incorporate the role of inequality to draw attention to the ways that membership in multiple categories places individuals and groups in asymmetrical relations, with effects on their perceptions, experiences, and outcomes. This question helps researchers to view constructs such as race or ethnicity as structural categories and social constructs rather than primarily as characteristics of individuals. Considering the role of inequality may help researchers to view individuals as embedded in cultural and historical contexts. There is a tendency in child maltreatment research to look “inside” groups or “downstream,” for example looking for cultural values that explain elevated levels of physical abuse in a specific ethnic group. Child maltreatment less frequently looks “upstream” at wider processes, for example disparities in service availability that make services inaccessible to some groups (Weber & Parra-Medina, 2003). Considering the role of inequality can help researchers “zoom out” to macro processes involving inequality, leading to differences in outcomes for children and families. Moreover, answering the question about inequality’s role helps avoid the tendency found in child maltreatment research to treat socially constructed categories (e.g., “Blacks” or “Whites”) as if they are static and unrelated to time and context. Instead, they can be properly understood as concepts constructed through historical and current social practices. Third, research should look for similarities across categories viewed as inherently different, challenging the assumption that these categories are homogeneous to begin with. This question opens the possibility of identifying commonalities across groups, even those perceived as essentially different or dichotomous by conventional categorization (i.e., men vs. women; immigrants vs. natives). These three issues or questions (Cole, 2009) encourage researchers to move beyond an approach in which social categories are operationalized solely through demographic factors or identities, offering new ways to understand the complex causality that characterizes child maltreatment. Methods for conducting intersectionality-informed qualitative, quantitative, or mixed-methods research have received increasing attention (e.g., Bowleg, 2012; Cole, 2009; McCall, 2005; Warner, 2008). Adopting intersectionality in child maltreatment research may allow researchers to look both “upstream” and “downstream” (Weber & Parra-Medina, 2003) – shifting between zooming-in to study specific groups in-depth, and zooming-out to understand powerful structural forces. Giving more weight to analyzing the interplay of micro and macro levels can contribute to our efforts to provide more equitable services for families and their children. Intersectionality also can be incorporated in the design and delivery of services for children and their families (Lockhart & Mitchell, 2010). At the micro level, programs should accommodate intersectionality by refraining from use of overly general categories (i.e., adolescent girls, Black families) in favor of multiple intersecting dimensions of identity. At the same time, programs should address macro level forces such as racism and sexism. Intersectionality also can address a critique that cultural competence focuses on gaining knowledge about “others” (Ben-Ari & Strier, 2010) but neglects societal bias and discrimination (Sisneros, Stakeman, Joyner, & Schmitz, 2008). Garcia (2009), for example, introduced a Latino Child Welfare Research and Practice Model to understand the contextual pathways contributing to vulnerability and cumulative risk of Latinos entering the child welfare system. Gracia argues that lack of attention to the multiple and interlocking contextual dimensions of environment increases the risk of Latino children entering the child welfare system. He suggests an integrative model that incorporates Latinos’ experiences within five contextual dimensions of environment: (a) physical environment, (b) individual, familial and social environment, (c) institutional and structural factors, (d) socio-political context, and (e) subjective perceptions of environments. These five contextual pathways can act either as risk or protective factors for Latino mental health and well-being. Adopting an intersectionalityinformed approach, the model incorporates contextual pathways that are situated in time and place, rooted in culture, and driven by macro social structures (Garcia, 2009). Another example is an intervention program based on intersectional theory targeting adolescent Israeli girls living in poverty and at risk of dropping out of school. The program consisted of group work dealing with the girls’ everyday experiences with regard to five elements: gender, ethnicity, class, sexuality and employment. The program had two phases. First, social workers received training to acquaint them with the concept of intersectionality in order to understand the girls’ realities. The second phase was a year-long group intervention with the girls to help them to frame their everyday experiences in terms of oppression, marginalization and social injustice relating to these five categories. This program

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illustrated the possibility of engaging service users and social workers in socio-political talk over personal issues – addressing intersectionality on both micro and macro levels (Krumer-Nevo & Komem, 2013). As this example shows, professional training is critical in developing programs that incorporate intersectionality. This approach moves beyond group-specific cultural knowledge to recognition that ethnic minority groups hold multiple social statuses that interact with one another. Moreover, it recognizes that disadvantaged groups in society live under personal, institutional, and cultural forces that may restrict, oppress, and prevent them from equal access to resources (Nadan & BenAri, 2013; Sisneros et al., 2008). Such calls to revise curriculum content and to challenge cultural competence models from an intersectional perspective have been included in training programs for physicians (Powell-Sears, 2012), social workers (Murphy et al., 2009), and child welfare workers (Ortega & Coulborn, 2011). In sum, the conceptual framework of intersectionality has significant potential for guiding future research, practice, policy and advocacy agendas and actions by focusing on the reciprocal relations between structural analyses and the subjective experiences of children and families (Lockhart & Mitchell, 2010; McCall, 2005; Sokoloff & Dupont, 2005) These attributes of intersectionality have potential for enhanced understanding of the complexities of child maltreatment.

Neighborhood-Level Research Another framework that allows consideration of multiple levels of influence, including culture and context, is an ecological framework (National Research Council, 1993). An ecological framework, first promoted by Bronfenbrenner (1979), locates individual development as nested in families, neighborhoods and communities, and the larger socio-cultural environment. Thus, from an ecological perspective, numerous factors simultaneously operating in a series of nested environments, ranging from the micro-environment of the family to the macro-environment of society, interact to increase or decrease the likelihood of maltreatment (Bronfenbrenner, Moen, & Garbarino, 1984; Cicchetti & Lynch, 1993). Neighborhood as one ecological level has been a promising arena for research on the influence of context on child maltreatment in large part because it is geographically bounded and thus amenable to mixed methods and multi-level research (e.g., Coulton et al., 2007; Korbin & Coulton, 1997). Research on neighborhood settings and maltreatment has identified three main pathways through which neighborhood settings may influence maltreatment: changes in neighborhood conditions (structural factors, social processes and dis-amenities), changes in neighborhood social services, and changes in the reporting and substantiation of maltreatment by professionals and non-professionals (see Coulton et al., 2007). Each of these pathways is discussed below.

Neighborhood Conditions – Structural Factors, Processes, Dis-amenities Structural factors are so named because they reflect the social and economic structure of urban settlement patterns. Research indicates that neighborhood structural factors are linked to maltreatment via multiple neighborhood processes involving social organization and control. Neighborhoods with stronger social organization and collective efficacy (a working trust and shared expectation of neighbors to intervene for common goals such as childraising) (Morenoff, Sampson, & Raudenbush, 2001; Sampson, Raudenbush, & Earls, 1997) are theorized to support families and promote pro-social norms and behavior, leading to lower incidence of child maltreatment. In contrast, decreased social control, decreased cohesion or social connection/integration of neighbors (Garbarino & Kostelny, 1992; Garbarino & Sherman, 1980; Korbin, Coulton, Chard, Platt-Houston, & Su, 1998; Vinson, Baldry, & Hargreaves, 1996) and decreased collective efficacy are thought to curtail families’ abilities to obtain child-related assistance from neighbors, and also decrease neighbors’ abilities to share, exchange, and monitor child-raising tasks. Several dimensions of neighborhood structure are important. Concentrated disadvantage, residential instability and immigrant concentration have been identified in urban sociology as consistent predictors of decreased collective efficacy and markers of social disorganization (Morenoff, 2003; Sampson et al., 1997; Sampson, 1985). Another dimension of neighborhood structure – concentration of wealth – has been linked specifically to parenting and child development outcomes through processes involving parent role modeling, peer influence, and engagement in high-quality institutions serving children and families (Leventhal & Brooks-Gunn, 2000). Our own study of Cleveland, Ohio, neighborhoods revealed that in addition to impoverishment and residential instability, a high concentration of children relative to adults was linked to greater child maltreatment rates (Coulton et al., 1995, 1999). In addition to structural factors, neighborhood dis-amenities are exposures to undesirable conditions such as blight, crime, violence, alcohol outlets, and drug trafficking. Following theoretical perspectives associated with cumulative risk (Evans, 2004, 2006) and routine activities (Cohen & Felson, 1979), if these adverse conditions are concentrated in neighborhoods they may contribute to child maltreatment. Severity of exposure to dis-amenities may vary over time and space through both internal (e.g., changes in collective efficacy) and external (e.g., regional drug markets, predatory lending) forces in the neighborhood. Structural factors and dis-amenities tend to be correlated through processes of selection of neighborhoods in which to live. Thus, poor families may be able to afford only blighted housing or homes in high-crime neighborhoods.

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Social Services Growing evidence indicates that social services such as home visiting programs (Howard & Brooks-Gunn, 2009; Zielinski, Eckenrode, & Olds, 2009), high quality child care (Reynolds, Temple, & Ou, 2003), income support services including Temporary Assistance for Needy Families (TANF) (Beimers & Coulton, 2011), and neighborhood-based child welfare services (Crampton, Usher, Wildfire, Webster, & Cuccaro-Alamin, 2011) (e.g., presence of neighborhood representatives and other key participants in meetings around foster care placement of children) may reduce child maltreatment on an individual or family level. However, there also is emerging evidence of neighborhood effects of social services on maltreatment. For example, availability of licensed child care and preschool spaces is related to the number of reports of suspected child maltreatment (Klein, 2011). Neighborhood Differences in the Definition, Reporting and Substantiation of Maltreatment Neighborhood-level differences in the definition, reporting, and substantiation (confirmation) of child maltreatment by mandated reporters (e.g., professional social workers, teachers) and non-mandated reporters (e.g., non-professionals such as neighbors, friends), or both, may produce differences in child maltreatment rates across neighborhoods regardless of actual maltreatment behaviors (Coulton et al., 2007). Although results are certainly not uniform (Drake & Zuravin, 1998; Drake et al., 2011), there is some evidence of systematic racial, ethnic, and social class biases in professionals’ handling of maltreatment reports (Dettlaff et al., 2011; Drake & Pandey, 1996; Rivaux et al., 2008). Such biases could differentially shape neighborhood rates in areas where racial, ethnic, and class make-up of neighborhoods differ. Our earlier Cleveland study (Korbin, Coulton, Lindstrom-Ufuti, & Spilsbury, 2000) found that neighborhood residents’ definitions of child maltreatment varied by neighborhood structural conditions. Those living in socially disordered neighborhoods were more likely to attribute maltreatment to poverty and family structure. However, residents of better-off neighborhoods were more likely to include a lack of moral values in their attributions. In short, for reasons that require better understanding, neighborhoods differ greatly in the level of child maltreatment that occurs in them. The pathways outlined above all comprise mechanisms through which neighborhoods may influence child maltreatment behaviors, rates, or both. Understanding the contextual influences that shape child maltreatment has significant potential to influence child welfare policy by identifying specific neighborhood conditions, service elements, and definition/reporting practices linked to reduced maltreatment rates. Summary and Future Directions It has been 20 years since members of the U.S. Advisory Board (Melton & Barry, 1994) edited a collection of papers commissioned in preparation for its 1993 report, Neighbors Helping Neighbors. It has also been approximately 20 years since the publication of the National Research Council’s 1993 report, Understanding Child Abuse and Neglect. In the intervening years, research on child maltreatment has shown a significant increase, as reflected in a second report from the National Research Council and the Institute of Medicine, New Directions in Child Abuse and Neglect Research (Petersen et al., 2014). The report emphasized the complexity of the issue and the significant gaps that remain in our knowledge. Among these gaps is the etiology of child maltreatment: “The causes of child abuse and neglect need to be understood with greater specificity if the problem is to be prevented and treated more effectively” (Petersen et al., 2014, p. 2). In this current article, we have argued for increased attention to the role of culture and context in the etiology of child maltreatment. Korbin’s (1994) chapter argued for better understanding of the role of culture by “unpacking” those cultural factors thought to contribute to child maltreatment. In the current article, we advocate application of the framework of intersectionality to understand how multiple identities interact with larger cultural and social forces. The 1994 chapter also supported neighborhood research as an ecological level for understanding the etiology of child maltreatment. This current article summarizes advances made in neighborhood based research and suggests that multiple pathways of neighborhood effects need to be considered. Significant progress has been made in understanding child maltreatment, but the complexity of the problem continues to pose challenges. Attention to culture and context may facilitate the expansion of knowledge about the basic etiology of child maltreatment to enable further progress in the prevention of child maltreatment in the next 20 years. References Amodeo, M., Griffin, M. L., Fassler, I. R., Clay, C. M., & Ellis, M. A. (2006). Childhood sexual abuse among Black women and White women from two-parent families. Child Maltreatment, 11, 237–246. Ards, S. D., Myers, S. L., Malkis Erin, A., & Zhou, L. (2003). Racial disproportionality in reported and substained child abuse and neglect: An examination of systematic bias. Children and Youth Services Review, 25, 375–392. Barn, R. (2007). Race, ethnicity and child welfare: A fine balancing act. British Journal of Social Work, 37, 1425–1434. Bartholet, E. (2009). The racial disproportionality movement in child welfare: False facts and dangerous directions. Arizona Law Review, 51, 871–932. Beimers, D., & Coulton, C. J. (2011). Do employment and type of exit influence child maltreatment among families leaving temporary assistance for needy families? Children and Youth Services Review, 33, 1112–1119. Ben-Ari, A., & Strier, R. (2010). Rethinking cultural competence: What can we learn from Levinas? British Journal of Social Work, 40, 2155–2167.

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