Small Upswing in Child Abuse Despite Reports, Abuse of smallest babies may have risen, study finds

Small Upswing in Child Abuse Despite Reports
By Crystal Phend, Senior Staff Writer, MedPage Today
October 01, 2012

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

A national study found that serious injuries from child abuse appear to have risen modestly over the past decade or so, and suggested that downward trends in other studies of abuse may reflect reporting changes rather than real improvement.

Hospitalization for abuse-related injury rose 4.9% overall among children 18 and under over the 12-year span from 1997 through 2009, wrote John Leventhal, MD, and Julie Gaither, RN, MPH, MPhil, both of Yale University in New Haven, Conn.

Children were increasingly likely to die from these injuries before discharge as well, they reported in the November issue of Pediatrics.

However, “these results are in sharp contrast to data from child protective services,” they noted. A national reporting system from these agencies indicated a 55% decline in substantiated child abuse cases from 1992 through 2009.

A second more extensive report by the Congress-mandated National Incidence Studies suggested a 23% decline in physical abuse.

While called evidence of “positive changes in the provision of services to children and families, there have been concerns that some of this decrease may be due to changes in reporting of cases to child protective services agencies and changes in which cases get investigated by child protective services and which cases are actually substantiated as physical abuse,” Leventhal and Gaither wrote….

http://www.medpagetoday.com/Pediatrics/DomesticViolence/35038

 

Abuse of smallest babies may have risen, study finds
By Maggie Fox, NBC News  9/30/12

A new look at child abuse reports suggests there may have been a small but worrying rise in injuries to babies over the past decade or so. While most research suggests child abuse is down overall, the report published on Monday in the journal Pediatrics shows infants are far from safe.

The study contradicts government data collected over the same time, and it shows that health officials need to take a better look at whether child abuse is getting better, worse or staying the same, experts said.

“I think it’s premature to make any conclusions about whether it is going up or down,” says Dr. James Anderst, chief of the section on child abuse and neglect at Children’s Mercy Hospitals and Clinics in Kansas City, Mo., who was not involved in the study. “Medical providers may be getting better at identifying abuse over time.”….

Child abuse is a serious problem in the United States. The Centers for Disease Control and Prevention says more than 740,000 children and youth are treated in hospital emergency departments for injuries resulting from violence every year.

“Child abuse, neglect or violence can actually affect the development of a child’s brain – impacting the child now and for years to come. Our Adverse Childhood Experiences (ACE) study shows a connection between child maltreatment and some of the nation’s worst health problems, including depression and heart disease,” CDC child abuse expert Linda Degutis says in a blog on the agency’s website….

http://vitals.nbcnews.com/_news/2012/10/01/14163696-abuse-of-smallest-babies-may-have-risen-study-finds?lite

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults

Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study -

American Journal of Preventive Medicine
Volume 14, Issue 4 , Pages 245-258, May 1998

Vincent J Felitti MD, FACP, Robert F Anda MD, MS, Dale Nordenberg MD,    David F Williamson MS, PhD, Alison M Spitz MS, MPH, Valerie Edwards BA,     Mary P Koss PhD, James S Marks MD, MPH

Abstract

Background: The relationship of health risk behavior and disease in adulthood to the breadth of exposure to childhood emotional, physical, or sexual abuse, and household dysfunction during childhood has not previously been described.

Methods: A questionnaire about adverse childhood experiences was mailed to 13,494 adults who had completed a standardized medical evaluation at a large HMO; 9,508 (70.5%) responded. Seven categories of adverse childhood experiences were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of these adverse childhood experiences was then compared to measures of adult risk behavior, health status, and disease. Logistic regression was used to adjust for effects of demographic factors on the association between the cumulative number of categories of childhood exposures (range: 0–7) and risk factors for the leading causes of death in adult life.

Results: More than half of respondents reported at least one, and one-fourth reported =2 categories of childhood exposures. We found a graded relationship between the number of categories of childhood exposure and each of the adult health risk behaviors and diseases that were studied (P < .001). Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, =50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.

Conclusions: We found a strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several of the leading causes of death in adults.

….However, our estimates of the prevalence of childhood exposures are similar to estimates from nationally representative surveys, indicating that the experiences of our study participants are comparable to the larger population of U.S. adults. In our study, 23.5% of participants reported having grown up with an alcohol abuser; the 1988 National Health Interview Survey estimated that 18.1% of adults had lived with an alcohol abuser during childhood. Contact sexual abuse was reported by 22% of respondents (28% of women and 16% of men) in our study. A national telephone survey of adults in 1990 using similar criteria for sexual abuse estimated that 27% of women and 16% of men had been sexually abused.

http://www.ajpmonline.org/article/S0749-3797%2898%2900017-8/fulltext