Study: Child abuse bigger threat than SIDS

4,600 children hospitalized with serious injuries 

By Frederik Joelving

updated 2/6/2012 10:14:15 AM ET

MSNBC: Nearly 4,600 U.S. children were hospitalized with broken bones, traumatic brain injury and other serious damage caused by physical abuse in 2006, according to a new report.


Babies younger than one were the most common victims, with 58 cases per 100,000 infants. That makes serious abuse a bigger threat to infant safety than SIDS, or sudden infant death syndrome, researchers say in the report.

"There is a national campaign to prevent SIDS," said Dr. John Leventhal of Yale University, who led the new study. "We need a national campaign related to child abuse where every parent is reminded that kids can get injured."

The new study, published Monday in the journal Pediatrics, is the first broad U.S. estimate of serious injuries due to child abuse.

Based on data from the 2006 Kids' Inpatient Database, the last such numbers available, Leventhal's team found that six out of every 100,000 children under 18 were hospitalized with injuries ranging from burns to wounds to brain injuries and bone fractures.

The children spent an average of one week in the hospital; 300 of them died.

The rate of abuse was highest among children under one, particularly if they were covered by Medicaid, the government's health insurance for the poor. One out of every 752 of those infants landed in the hospital due to maltreatment.

"Medicaid is just a marker of poverty, and poverty leads to stress," said Leventhal, who is the medical director of the Yale-New Haven Children's Hospital Child Abuse Program.

Last year, a study from four U.S. states showed a clear spike in abusive brain injuries following the financial crash in late 2007, a finding researchers chalked up to the added pressure on parents.

Mom's hug revives baby that was pronounced dead
In that study, too, toddlers appeared to be at higher risk. That led researchers to suggest the maltreatment might have been triggered by crying.

If a caretaker shakes a baby violently to make him or her stop crying, they can cause "shaken baby syndrome," in which the brain bumps up against the skull and starts bleeding.

Leventhal said babies may also be more vulnerable that older kids.

"The most serious injuries tend to be in the younger kids," he told Reuters Health.

Home birth advocate dies in childbirth
The researchers estimate that the hospitalizations cost about $73.8 million in 2006, although that's only a fraction of the overall cost of abuse to society.

"This is a serious problem that affects young children," said Leventhal, whose team is now examining more recent data to refine the findings. "We need to figure out a way to help parents do better."

Copyright 2012 Thomson Reuters.

CDC: Child abuse and neglect cost the United States $124 billion

For Immediate Release: February 1, 2012
Contact :CDC Division of News and Electronic Media
(404) 639-3286

Rivals cost of other high profile public health problems

The total lifetime estimated financial costs associated with just one year of confirmed cases of child maltreatment (physical abuse, sexual abuse, psychological abuse and neglect) is approximately $124 billion, according to a report released by the Centers for Disease Control and Prevention, published in Child Abuse and Neglect, The International Journal.

This study looked at confirmed child maltreatment cases, 1,740 fatal and 579,000 non–fatal, for a 12–month period. The lifetime cost for each victim of child maltreatment who lived was $210,012, which is comparable to other costly health conditions, such as stroke with a lifetime cost per person estimated at $159,846 or type 2 diabetes, which is estimated between $181,000 and $253,000.  The costs of each death due to child maltreatment are even higher.

“No child should ever be the victim of abuse or neglect – nor do they have to be.  The human and financial costs can be prevented through prevention of child maltreatment,” said Linda C. Degutis, Dr.P.H., M.S.N., director of CDC′s National Center for Injury Prevention and Control.

Child maltreatment has been shown to have many negative effects on survivors, including poorer health, social and emotional difficulties, and decreased economic productivity.  This CDC study found these negative effects over a survivor′s lifetime generate many costs that impact the nation′s health care, education, criminal justice and welfare systems. 
Key findings:

• The estimated average lifetime cost per victim of nonfatal child maltreatment includes:
• $32,648 in childhood health care costs
• $10,530 in adult medical costs
• $144,360 in productivity losses
• $7,728 in child welfare costs
• $6,747 in criminal justice costs
• $7,999 in special education costs

• The estimated average lifetime cost per death includes:
• $14,100 in medical costs
• $1,258,800 in productivity losses

Child maltreatment can also be linked to many emotional, behavioral, and physical health problems. Associated emotional and behavioral problems include aggression, conduct disorder, delinquency, antisocial behavior, substance abuse, intimate partner violence, teenage pregnancy, anxiety, depression, and suicide.
Past research suggests that child maltreatment is a complicated problem, and so its solutions cannot be simple. An individual parent or caregiver′s behavior is influenced by a range inter–related factors such as how they were raised, their parenting skills, the level of stress in their life, and the living conditions in their community.  Because of this complexity, it is critical to invest in effective strategies that touch on all sectors of society. 

“Federal, state, and local public health agencies as well as policymakers must advance the awareness of the lifetime economic impact of child maltreatment and take immediate action with the same momentum and intensity dedicated to other high profile public health problems –in order to save lives, protect the public′s health, and save money,” said Dr. Degutis.

Several programs have demonstrated reductions in child maltreatment and have great potential to reduce the human and economic toll on our society.  Several examples of effective programs include:

• Nurse–Family Partnership, an evidence–based community health program. Partners a registered nurse with a first–time mother during pregnancy and continues through the child′s second birthday.   http://www.nursefamilypartnership.org/
• Early Start, provides coordinated, family–centered system of services:  http://www.dds.ca.gov/earlystart/ California′s response to federal legislation providing early intervention services to infant and toddlers with disabilities and their families.
• Triple P, a multilevel parenting and family support system: http://www.triplep–america.com/ Aims to prevent severe emotional and behavioral disturbances in children by promoting positive and nurturing relationships between parent and child.

The article, "The economic burden of child maltreatment in the United States and implications for prevention," is available at http://www.sciencedirect.com/science/journal/aip/01452134.

CDC′s Injury Center works to prevent injuries and violence and their adverse health consequences.  For more information on public health child maltreatment prevention activities and research, please visit http://www.cdc.gov/ViolencePrevention/childmaltreatment.

If you know or suspect a child is being abused, contact the National Child Abuse Hotline at 1–800–4–A–CHILD or visit the Childhelp website.