Recession Tied to Rise in Child Abuse Injuries

Incidence of 'shaken baby syndrome' and other head trauma almost doubled, study found

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Monday, September 19, 2011

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Child Abuse

MONDAY, Sept. 19 (HealthDay News) -- The stress of unemployment, foreclosures and putting food on the table may have helped drive a spike up in shaken baby syndrome and other types of abusive head trauma seen among infants and young children during the recent recession.

A new study examined the rate of abusive head trauma seen among kids under age 5 in various U.S. locales from 2004 to 2009. Researchers found that the rate of such trauma rose from about 9 per 100,000 children to nearly 15 per 100,000 during that time period -- coinciding with the onset of the recession and massive job losses.

"I wasn't surprised, but I am disturbed," said study lead author Dr. Rachel P. Berger, a pediatrician at the Children's Hospital of Pittsburgh. "This is the first really long recession in really long time, and the medical diagnoses of abusive head trauma have increased in it."

Calling the findings "highly concerning," the researchers noted that abusive head trauma is the leading cause of death from child abuse and among the most common causes of traumatic brain injury among infants.

The study, published in the October issue of Pediatrics, can't definitely say that the increase is related to tough economic times, but unemployment was up in all of the regions included in the new study. Although child abuse occurs in all economic classes, previous research has also shown that poverty is linked to the risk of physical abuse.

Overall, there were 422 abusive head traumas in children under age 5 in 74 counties during the five-year study period. Of these, 76 percent occurred in children younger than 1. They took place in 76 counties throughout Pennsylvania, Ohio and Seattle.

As to what could make a stressed-out caregiver snap, she said that among infants, crying may be the trigger, but as children age, it could be biting, toilet training or defiance issues.

This is not the first study to document a rise in abusive head trauma during the recent recession. A team of researchers from University Hospital's Rainbow Babies and Children's Hospital in Cleveland also reported a doubling of such injuries during the recent recession. Those findings were presented in April at the American Association of Neurological Surgeons' meeting in Denver.

So, is there anything that can be done to reduce economic hard times' impact on the health of children? Berger believes that education and more support for struggling families may help put a dent in the troubling statistics she's seen.

"Stress and poverty are risk factors for child abuse," agreed Dr. Peter Sherman, a pediatrician and director of the residency program in social pediatrics at Montefiore Medical Center in New York City. "If people are stressed out, it's not a big stretch that they are at high risk for being abusive."

Part of the onus to protect these children also falls on their doctors. "It really suggests that as clinicians, we need to look at stresses on parents," Sherman said. That includes looking at what else is going on in their lives, such as maternal depression, risk of homelessness and/or job loss. "We need to do better," he concluded.

SOURCES: Rachel P. Berger, MD, pediatrician, Childrens Hospital of Pittsburgh; Peter Sherman, MD, pediatrician and director, residency program in social pediatrics, Montefiore Medical Center, New York City; October 2011, Pediatrics

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