Research led by Christopher Wildeman, and funded by a pilot grant from DPRC, examines the lifelong consequences of childhood maltreatment and state intervention. By analyzing large-scale national data, Wildeman and his colleagues have documented how experiences of abuse and neglect during childhood continue to shape an individual's health, education, and well-being decades later.
The Pervasiveness of System Contact and Racial Inequality
To begin, the research sheds light on how common it is for American families to interact with Child Protective Services (CPS). In a study of the 20 most populous U.S. counties, researchers found that roughly 1 in 3 children will experience a CPS investigation before they turn 18.
However, these experiences are not distributed equally. In a study published in PNAS the authors document stark racial and ethnic inequalities, particularly for Black children, who face investigation rates exceeding 50% in more than half of the counties studied. These high rates of system contact often lead to later-stage interventions, such as foster care placement or the termination of parental rights, at much higher frequencies than for other groups. This work highlights that while CPS intervention is a common part of childhood for many, the safety net operates very differently depending on a child's race and where they live.
Complex Patterns of Foster Care and Future Outcomes
Subsequent research explores the complex relationship between the type of abuse a child suffers and whether the state intervenes by placing them in foster care. An article published in Social Forces finds that state intervention is not always a direct response to the frequency of abuse.
By identifying specific patterns of experience, the authors find two particularly vulnerable groups:
- Severe Abuse without Foster Care: One group of children experienced recurring and severe abuse but was rarely placed in foster care. In early adulthood, these individuals reported worse overall health outcomes.
- Frequent Foster Care with Less Frequent Abuse: Another group—disproportionately Black and male—was more likely to be placed in foster care even when the reported abuse was less frequent. These individuals were more likely to face educational challenges, such as dropping out of high school, possibly due to the instability often associated with foster care placements.
Health Risks Persist into Mid-life
One of the most significant findings from the research is that the health consequences of childhood maltreatment do not fade with time; instead, they persist well into a person’s 30s and 40s. Using data from a nationally representative sample of nearly 10,000 participants, a recent study in SSM - Mental Health finds that individuals who experienced physical neglect or sexual abuse as children face significantly higher risks of depression and smoking in mid-life.
The research also emphasizes the impact of "multi-victimization"—experiencing more than one type of abuse or neglect. Individuals in this group were found to be at a much higher risk for a range of health issues, including obesity and cardiovascular disease, compared to those who never experienced maltreatment. These findings underscore the need for durable health support systems that address the long-term biological and behavioral effects of early childhood trauma.
Conclusion
Collectively, these studies provide a data-driven foundation for understanding that childhood maltreatment is a major public health and social issue. The work of Dr. Wildeman and his team demonstrates that reducing maltreatment and improving how the state responds to it has the potential to yield durable benefits for both individual lives and the health of the entire population.
Citations
- Frank Edwards, Sara Wakefield, Kieran Healy, and Christopher Wildeman. (2021). Contact with Child Protective Services is pervasive but unequally distributed by race and ethnicity in large US counties. Proceedings of the National Academy of Sciences, 118(30). https://doi.org/10.1073/pnas.2106272118
- Martin Eiermann, Garrett Baker, and Christopher Wildeman. (2025). Discordant patterns and adulthood consequences of childhood maltreatment and foster care placement. Social Forces, 00, 1–22. https://doi.org/10.1093/sf/soaf077
- Christopher Wildeman, Garrett Baker, Hedwig Lee, and Martin Eiermann. (2026). Associations between childhood maltreatment and mid-life health risks and risky health behaviors in a nationally representative sample. SSM - Mental Health, 9, 100625. https://doi.org/10.1016/j.ssmmh.2026.100625