Statement of purpose One in eight children is estimated to experience child abuse and neglect (CAN) before 18 years of age. Ohio has a drug overdose death rate nearly twice that of the United States (19.8 per 100,00). Prior research demonstrates that parents who misuse substances are more likely to engage in abusive and neglectful parenting. However, there is a significant variation in rates of drug overdoses and CAN across neighborhood areas. Therefore, understanding how neighborhood structural characteristics and social processes can impact the relationships between opioid misuse and CAN is pivotal. This study aims to provide a greater understanding of the environmental and social mechanisms that support or hinder maltreating behaviors by caregivers.

Methods/Approach In the first phase of this study, to analyze the role of opioid overdoses on CAN, Bayesian space-time models were conducted using data from Ohio’s Statewide Integrated Child Welfare Information System, naloxone administration data obtained by the Ohio Emergency Medical Services Incident Reporting System, and information on opioid dispensing practices from the Ohio Automated Rx Reporting System. We have selected 16 census block groups in Ohio, that have at least 500 children in them (CBGs), providing equal representation from urban, suburban, rural, and Appalachian communities. Each of the 4 regions contributes 2 CBGs with higher (high risk) and lower (low risk) than model-based CAN rates. In the current phase of this study, we are interviewing caregivers residing in the CBGs and key informants who serve those in the CBGs to discuss neighborhood social processes, resources available to families, their view on the impact of the opioid crisis in the community, their view on parenting practices within the community, and sociodemographic variables.

Significance We believe that one way of creating and sustaining safer environments for children is to develop CAN prevention efforts that focus on strengthening neighborhood structures and social processes.