Cases of physical abuse of children declined by 55 percent from 1992 through 2009, according to national data from child protective services in the U.S. — but a just-published study in Pediatrics offers a very different story. John Leventhal, MD, and Julie Gaither, RN, MPH, MPhil, of Yale University found that, from 1997 through 2009, hospitalization for physical abuse-related injuries among children 18 and under rose overall by 4.9 percent.
New Study Looked At Data From Hospital Discharges
As Leventhal and Gaither point out, “no study has tracked the occurrence of serious injuries due to physical abuse.” Rather than using data from child protective agencies, they analyzed data about the actual physical injuries suffered by children, drawing on data from the Kids’ Inpatient Database, which provides a sample of discharges from hospitals in the U.S.
Besides finding that hospitalizations due to child abuse have increased, Leventhal and Gaither learned that children who had been hospitalized were more likely to die. Plus, the greatest increase (10.9 percent) in serious injuries was to babies; 54 precent of the hospitalizations were for children under the age of one year old.
The type of injuries suffered by children who had been hospitalized were mostly fractures, followed by open wounds or skin injuries, traumatic brain injury (these accounted for at least one-third of the injuries), burns, abdominal injuries and other injuries.
Is Child Abuse Decreasing or Increasing?
According to ABC News, another “more extensive” report, the Congress-mandated National Incidence Studies, suggested that there has been a 23 percent decline in physical abuse. Are these and the child protective services data completely off the mark, or are the Yale researchers?
These contradictory findings reveal that the previously reported decline in abuse “may be due to differences in reporting, rather than a true reduction in abuse-related injuries,” says Time magazine. For instance, child protective agencies take all physical abuse into account in their reports, while the Yale researchers were specifically considering injuries so severe that they had required hospitalization.
One conclusion that can be drawn thanks to the new Pediatrics study is that we need to look at numerous types of data to get an accurate picture about child abuse and whether it is declining or not. Leventhal and Gaither also found that serious injuries related to physical abuse had dramatically increased among children on Medicaid, rising from 59 to 74 percent. As they write, “that three-quarters of the abused children in 2009 were on Medicaid highlights the importance of poverty as a stressor for families and suggests that funding from Medicaid might target the prevention of these serious injuries.”
In addition, the disparities between the new Pediatrics study and earlier findings are a reminder about how difficult it can be to get truly accurate data about child abuse and how often it occurs. The data from the child protective agencies and from the hospitals about children who had been abused and discharged are from reported instances of abuse. But we need to keep in mind whether there might be cases that are not detected and therefore not reported, perhaps because the abuse has occurred in a family in which people “would never think” that such could occur.
Such thinking, it can be argued, was one reason that the sexual abuse that former Penn State University football coach Jerry Sandusky inflicted for years on at least ten young individuals while no one — no one who would be listened to, that is– said anything. Abuse of any sort, physical or sexual, can leave a child with lifelong psychic scars that remain long, long after bruises and bones have healed. We should do everything we can to detect and prevent abuse, certainly before a child has to be hospitalized for brutal, in some cases life-threatening, injuries.
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