October 1, 2012
Cases Of Serious Child Abuse On The Rise, Fatalities As Well
Lawrence LeBlond for redOrbit.com - Your Universe Online
A recent national study has found that serious cases of child abuse have increased slightly over the last decade or longer, and has also suggested that downward trends found in previous studies have reflected more on reporting changes rather than real improvement in abuse cases.The Yale School of Medicine study, published in the November issue of Pediatrics (online Oct. 1), showed that between 1997 and 2009, cases of serious physical child abuse--including fractures, burns, and head trauma--increased nearly 5 percent among children 18 and under. The study also found, disturbingly, that children were increasingly likely to die from these injuries before discharge as well.
John Leventhal, MD, and Julie Gaither, RN, MPH, both of Yale University, said their findings are a significantly sharp contrast to data from child protective agencies, which have shown a 55 percent drop in cases of child abuse in the same timeframe. The Yale study, which is the first to track the occurrence of serious injuries due to physical abuse in hospitalized children, raises concerns that child protective agencies are basing data on reported cases only.
However, the contrast in figures could also be due to child protective services agencies´ reports stemming from all cases of physical abuse regardless of age or severity. The Yale study focused only on serious physical abuse.
Leventhal, professor of pediatrics at Yale, and director of the Child Abuse Programs at Yale-New Haven Children's Hospital, said results from Gaither's and his study “highlight the challenges of helping parents do better by their children and the importance of effective prevention programs to reduce serious abusive injuries in young children.”
He and Gaither studied data from the Kids' Inpatient Database (KID), a sample of discharges from hospitals in the United States. They examined cases where serious injuries related to child abuse occurred in the 12-year study period. Among the most serious cases were head injuries, burns, abdominal injuries and bone fractures. The database also provided information on demographics, including child age, gender, race and health insurance; whether the child died during hospitalization; and the length of stay at the hospital.
During the study period, Leventhal and Gaither found that the incidence of serious injury linked to abuse rose from 6.1 in 100,000 children in 1997, to 6.4 per 100,000 in 2009. Most of that upward trend came from abuse of the youngest children, where the serious injury incidence rose 10.9 percent among those under a year old. A decrease was actually seen in child abuse incidence in older children: about 9.1 percent from 3.3 to 3.0 per 100,000 children over the study period.
Most of the serious abuse-related injuries were fractures, rising from 40.2 percent in 1997 to 48.5 percent in 2009. Skin laceration and other open wounds also rose during the study period to 41.6 percent in 2009. Traumatic brain injury accounted for a third of injuries across the study period. Burns, abdominal injuries and other injuries accounted for about 10% each.
The researchers found that while duration of hospital stay for severe injury due to child abuse didn´t change over the 12-year period, in-hospital deaths rose from 0.25 to 0.36 per 100,000 children during the study period.
“Because there has been no decrease in the incidence of hospitalizations due to serious abuse in children, our results highlight the need to develop prevention programs that can reduce this significant morbidity (and mortality),” concluded Leventhal and Gaither.