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Kentucky’s child abuse rate is one of the highest in the U.S., according to the latest national report, with the commonwealth now nearly doubling the national child abuse rate.

The “Child Maltreatment 2024” report, released this year by the U.S. Department of Health & Human Services Children’s Bureau, found the rate of child maltreatment victims in Kentucky was 14.1 per 1,000 children. That means about 14 out of every 1,000 children in Kentucky experienced some form of abuse or neglect during 2024, maintaining the same rate as in 2023.

Indiana’s rate is slightly lower than Kentucky’s, at 13.4 victims out of every 1,000 children, but it is slightly higher than the state’s rate in 2023 at 11.5. Both states’ child maltreatment victimization rates are higher than the national average, which is 7.2 per 1,000 children. Kentucky and Indiana hold the fifth and ninth highest child maltreatment victimization rates in the country, respectively. The report found most child victims in Kentucky, Indiana and nationally were younger than age 1. Indiana holds the highest rate in the nation for abuse and neglect victims younger than age 1, at about 52 infants per 1,000.

More work to do

One of the most concerning findings for Kentucky in the 2024 report involves infants with prenatal substance exposure. States are required by federal law to ensure these infants have a plan of safe care in place when they leave the hospital.

According to the report, only 23.7% of Kentucky’s screened-in substance-exposed infants had such a plan, making Kentucky third lowest in the nation among states reporting this data.

“Kentucky’s Child Fatality and Near Fatality External Review Panel has been citing this as an issue for years,” said Melissa L. Currie, M.D., child abuse pediatrician and medical director, Norton Children’s Pediatric Protection Specialists. “We have so many child victims that end up with fatalities or near fatalities that were known to be substance exposed and did not have a plan of safe care. This national report confirms what we’re seeing on the panel and shows we have a lot of work to do around this issue.”

Kentucky also has the eighth highest rate of caregivers with substance use disorders, nearly 40% compared with the national average of about 25%.

Some silver linings

While the rate remained unchanged, the raw number of child victims in Kentucky decreased by 13% compared with 2020, which Dr. Currie called a “welcome bright spot.”

“It’s still too many children, but fewer kids being harmed is always good news,” she said.

Kentucky also is improving in one historically difficult area: identifying and substantiating psychological maltreatment. Kentucky now has the seventh highest number of substantiated psychological maltreatment cases, a sign that recognition and documentation are improving.

“Psychological maltreatment is incredibly harmful and often hard to substantiate,” Dr. Currie said. “Our team has worked hard to include more language about psychological maltreatment in our reports, and we’re finally seeing those efforts reflected in the data.”

Despite areas of progress, Dr. Currie emphasized that Kentucky remains in crisis.

“We continue to rank in the top five nationally for child maltreatment,” she said. “There are system issues, like plans of safe care and substance-exposed babies, that absolutely need improvement. But the bigger solution must be prevention. Until Kentucky invests upstream, we will keep reacting after abuse has already occurred.”

How to prevent child abuse

While child abuse remains a persistent problem, doctors have tips on how community members can help prevent it.

“Child abuse prevention truly begins with strengthening families,” said Kelly L. Dauk, M.D., chair, Norton Children’s Hospital Child Abuse Task Force, and pediatric hospitalist, Norton Children’s Inpatient Care. “When families are overwhelmed, their children are more vulnerable. Small, thoughtful gestures from friends, neighbors or extended family can make a meaningful difference. Strong, supported families create safer environments for children.”

• If you feel yourself getting overwhelmed, it’s OK to step away for a moment. Take deep breaths, listen to music, or reach out to someone you trust.
• New parents: Try to rest when your baby sleeps. Prioritizing your own rest helps you care for your baby.
• Learn about typical child behavior and development. For example, crying is how infants communicate — it is not a sign they are “bad” or “spoiled.”
• Keep a short list of friends or family members you can call for support when you need a break.
• If you know a parent who is stressed, offer to watch their children for an hour or two so they can recharge.
• Offer to run an errand for a neighbor with young children. Small gestures can greatly reduce daily stress.
• If you witness a tense moment, you can help diffuse it. Even a simple comment like, “I remember going through that, too,” can break the tension and protect the child.

April is Child Abuse Prevention Month. In Kentucky, the number to call to report suspected child abuse is (877) KY-SAFE1 (597-2331). The Childhelp National Child Abuse Hotline, (800) 4-A-CHILD (422-4453), offers professional crisis counselors who can provide intervention, information and referrals to emergency, social service and support resources. Calls are confidential.

In Kentucky, everyone is mandated to report a reasonable suspicion that maltreatment has occurred. Reporting child abuse and neglect is the right thing to do, and it’s the law.