Expert Commentary

Incidence of serious injuries due to physical abuse in the United States, 1997 to 2009

2012 from Yale University published in Pediatrics on a rise in the incidence of serious child abuse cases in the United States.

Studies have shown that child abuse can have long-term effects on both victims and society. According to the U.S. Department of Health and Human Services, such experiences can be associated with negative psychological and behavioral consequences for the victim well into adult life. Societal consequences include the costs associated with the child welfare and criminal justice systems, as well as the indirect costs associated with a loss of productivity due to underemployment.

National data from child protective services agencies (CPS) have shown a 55% decrease in the incidence of substantiated cases of physical abuse from 1992-2009. However, no study has previously tracked the occurrence of serious injuries due to physical abuse. A 2012 study from Yale University published in Pediatrics, “Incidence of Serious Injuries Due to Physical Abuse in the United States: 1997 to 2009,” analyzes national data from hospitalized children detailed in the Kids’ Patient Database, which provides a sample of hospital discharge information. The study’s findings strongly challenge data patterns from U.S. child protective services.

The study’s findings include:

  • The incidence of serious injuries due to physical abuse of children under the age of 18 increased by 4.9% over the period between 1997-2009. The incidence increased from 6.1 per 100,000 children in 1997 to 6.4 per 100,000 children in 2009.
  • For children under the age of 1, the incidence increased by 10.9%, from 56.2 to 62.3, per 100,000 children over this period. For the older children between the ages of 1 and 18, there was a decrease of 9.1%, from 3.3 to 3.0 per 100,000 children.
  • “The length of stay for the hospitalizations of children with abusive injuries did not change over time (mean 7.2 days in 1997 vs. 7.1 days in 2009). In contrast, there was a substantial increase in the incidence of deaths during the hospitalization in the abuse group. In 1997, the incidence of children dying due to abusive injuries was 0.25 per 100,000 children, and this increased to 0.36 per 100,000 children in 2009.”
  • A major demographic change in the group of abused children over time was that the percentage of cases coming from families on Medicaid increased substantially, from 59% to 74%.

The authors conclude that “the results indicate that there has been no major decrease and, in fact, a small, but statistically significant increase in the incidence of hospitalizations of children with serious injuries due to physical abuse from 1997 to 2009.” Given that government data showed a decrease in the incidence of child abuse in the 1990s, the authors question the accuracy of that data and express “concerns that some of this decrease may be due to changes in reporting of cases to CPS agencies and changes in which cases get investigated by CPS and which cases are actually substantiated as physical abuse.”

Tags: youth, children, safety, crime

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