Based on the significant effects of child abuse and neglect on health and wellbeing across the lifespan, child maltreatment is among the most pressing public health problems in the United States. Interventions aimed at neighborhood-level processes can complement individual-level efforts by promoting an environment that buffers against, rather than fosters, a maladaptive response to adversity. As support for place-based initiatives continues to grow, it is imperative that population-based evidence is used to guide intervention efforts. Applying concepts from spatial epidemiology through social determinants of health lens, we present a systematic review of the evidence on neighborhood context and variation in the rate of child welfare contact at the neighborhood-level. Three databases (PubMed, PsycInfo, and Proquest Digital Dissertations and Theses) were used for the literature search which identified 1100 references. After dual abstract and full text review, 19 distinct studies were included in the study. Within the major categories of neighborhood structure and processes, several neighborhood constructs were consistently associated child welfare outcomes – economic disadvantage, racial and ethnic composition, social disadvantage, and residential instability. However, despite consistency in studies of the total population, evidence of variation in the relationship (i.e., effect modification) for different racial and ethnic populations emerged. Though nearly all studies assessed neighborhood structure, only a few included neighborhood processes, a key piece of information for place-based interventions in social welfare. Further application of concepts from epidemiology and the meticulous reporting of research methods will increase confidence in the internal validity of future population-based research in child welfare.
