The recognition of child abuse in its multiple forms—physical, sexual, emotional abuse, and neglect—continues to be a considerable social and public health problem throughout the world. While every state, the District of Columbia, and the U.S. Territories mandate reporting by certain individuals, and most require training for those reporters, underreporting of suspected child abuse continues to be a problem.

Underreporting is often related to confusion, uncertainty, lack of knowledge about the signs of mistreatment, or the belief that the family can fix the problem on its own. A mandated reporter may genuinely feel that intervention will negatively affect the family and the child.

When the suspected abuser is someone trusted or respected in the community, a reporter may fear not being believed. If the reporter is a friend or acquaintance of the suspected abuser, the reporter may not want to cause trouble for their friend. Unfortunately, an abuser may threaten the mandated reporter, or the reporter may be concerned that a report may cause the abuser to harm the child.

Protecting the child’s safety and concern for a child’s emotional or mental health are primary reasons for filing a report of child abuse. Legal obligation is another reason to report suspected child abuse.

In 2023, the Administration for Children and Families (ACF) reported that more than 3 million children in the United States received either an investigation response or alternative response. Nearly 550,000 were determined to be victims of child abuse and neglect. Three-quarters of child victims experienced neglect, 17% were physically abused, more than 10% were sexually abused, nearly 7% were psychologically maltreated, and 0.2% were sex trafficked. Nationally, 2,000 children died from abuse and neglect (DHHS, 2025).

In New York State (2023), more than 190,000 referrals of child abuse or neglect received an investigation; nearly 57,000 were substantiated* victims. In 2021, two-thirds of child fatalities were younger than 3 years; close to one-half of child fatalities were younger than 1 year. Although the victimization rates are higher for girls, boys have a higher child fatality rate than girls (DHHS, 2023).

*Substantiated: An investigation disposition that concludes that the allegation of maltreatment or risk of maltreatment was supported or founded by state law or policy.

American Indian/Alaska Native children have the highest rate of child victimization followed by Black children. Child fatality rates are highest among Black/African American populations, followed by American Indian/Alaska Natives, and Native Hawaiian/Pacific Islanders (DHHS, 2025).

It is believed that overall, the numbers underestimate how many children are affected by maltreatment because many cases go unreported or undetected. Physical and emotional scars can last a lifetime and are linked to higher rates of alcoholism, drug abuse, depression, smoking, multiple sexual partners, suicide, and chronic disease.