In the aftermath of the Great Recession and the increased attention to the widening income gap, concern over the impact of inequality on children and families has risen. According to a nationwide study by Cornell researchers the list of bad outcomes associated with income inequality now includes child abuse and neglect.

The income inequality-child maltreatment study, to be published in the March 2014 edition of the peer-review journal Pediatrics, covers all 3,142 American counties from 2005-09, and is one of the most comprehensive of its kind and the first to target child abuse in places with the greatest gap between rich and poor.

"More equal societies, states and communities have fewer health and social problems than less equal ones - that much was known. Our study extends the list of unfavorable child outcomes associated with income inequality to include child abuse and neglect," said John Eckenrode, professor of human development and director of the Bronfenbrenner Center for Translational Research in the College of Human Ecology.

Nearly 3 million children younger than 18 years of age are abused physically, sexually or emotionally or are physically neglected each year in the United States, the Cornell researchers noted. That is about 4 percent of the youth population.

"We have known for some time that poverty is one of the strongest precursors of child abuse and neglect," Eckenrode said. "In this paper we were also interested in areas with wide variations in income - think of counties encompassing affluent suburbs and impoverished inner cities - and in the U.S. there is quite a lot of variation in inequality from county to county and state to state."

The damage inflicted on children by maltreatment doesn't stop when kids graduate - if they do - from school, the Cornell researchers observed. "Child maltreatment is a toxic stressor in the lives of children that may result in childhood mortality and morbidities and have lifelong effects on leading causes of death in adults," they wrote. "This is in addition to long-term effects on mental health, substance use, risky sexual behavior and criminal behavior ... increased rates of unemployment, poverty and Medicaid use in adulthood." Eckenrode noted that "reducing poverty and inequality would be the single most effective way to prevent maltreatment of children, but in addition there are proven programs that work to support parents and children and help to reduce the chances of abuse and neglect - clearly a multifaceted strategy is needed."

Results of the massive study will be published in the March 2014 journal, Pediatrics, as "Income Inequality and Child Maltreatment in the United States."