The cumulative incidence of each endpoint indicates the greatest risk during the first year of life followed by a fairly constant increase in risk to first maltreatment report. Maltreatment detected through linkage of multiple agencies data was nearly identical to child protective services (CPS) reports only, indicating that data linkages was hardly worth the effort. However some sources were only partially represented (e.g. Child Advocacy Centers).
Risk Age interval (Years)
[0,1) [1,2) [2,3) [3,4) [4,5) [5,6) First Multi-agency report 0.097 0.146 0.189 0.227 0.259 0.283 First CPS report 0.092 0.141 0.185 0.222 0.254 0.277 First CPS Screen-In Report 0.067 0.106 0.133 0.165 0.195 0.218 First CPS Substantiated Report 0.028 0.046 0.060 0.073 0.082 0.088
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For each of the types of endpoints measured the lifetable based estimates correctly map onto the hazard-based method. The hazard- based method used to estimate the risk to first event that accounted for death and emigration censoring was slightly increased from what is estimated when accounting for only death censoring. The difference between these estimates is more pronounced for agency reports compared with substantiated reports.
Accounting for censoring (Nelson-Aalen)
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Cumulative Incidence Stratified by Tricare birth
Due to the difference detected in loss-to-follow up we compared the hazard based cumulative risk estimates between the military (births delivered by Tricare) and nonmilitary populations in Alaska. We detected that although the Tricare births had minimal data representing events (as evidenced by the “long arms” of the F(t) line, the overall risk was similar to the total birth population of Alaska. Because of the similar risk and fact that we could measure emigration we included this population in the analysis to estimate the overall risk of having a maltreatment report by age five in the state of Alaska.
Risk Age interval (Years)
[0,1) [1,2) [2,3) [3,4) [4,5) [5,6) NonTricare paid births 0.097 0.147 0.184 0.225 0.255 0.277 Tricare paid births 0.084 0.124 0.226 0.226 0.280 0.280
1
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