Local macroeconomic trends and hospital admissions for child abuse, 2000– 2009
Date
2012
Journal Title
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Volume Title
Publisher
Pediatrics
Abstract
OBJECTIVE: To examine the relationship between local macroeconomic
indicators and physical abuse admission rates to pediatric
hospitals over time.
METHODS: Retrospective study of children admitted to 38 hospitals in
the Pediatric Hospital Information System database. Hospital data were
linked to unemployment, mortgage delinquency, and foreclosure data
for the associated metropolitan statistical areas. Primary outcomes
were admission rates for (1) physical abuse in children ,6 years
old, (2) non-birth, non-motor vehicle crash-related traumatic brain
injury (TBI) in infants ,1 year old (which carry high risk for abuse),
and (3) all-cause injuries. Poisson fixed-effects regression estimated
trends in admission rates and associations between those rates and
trends in unemployment, mortgage delinquency, and foreclosure.
RESULTS: Between 2000 and 2009, rates of physical abuse and high-risk
TBI admissions increased by 0.79% and 3.1% per year, respectively
(P # .02), whereas all-cause injury rates declined by 0.80% per
year (P , .001). Abuse and high-risk TBI admission rates were
associated with the current mortgage delinquency rate and with
the change in delinquency and foreclosure rates from the previous
year (P # .03). Neither abuse nor high-risk TBI rates were associated
with the current unemployment rate. The all-cause injury rate was
negatively associated with unemployment, delinquency, and foreclosure
rates (P # .007).
CONCLUSIONS: Multicenter hospital data show an increase in pediatric
admissions for physical abuse and high-risk TBI during a time of
declining all-cause injury rate. Abuse and high-risk TBI admission
rates increased in relationship to local mortgage delinquency and
foreclosure trends
Description
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Keywords
child safety, child abuse, maltreatment, head trauma, head injuries
Citation
Wood, J. N., Medina, S. P., Feudtner, C., Luan, X., Localio, R., Fieldston, E. S., & Rubin, D. M. (2012). Local macroeconomic trends and hospital admissions for child abuse, 2000– 2009. Pediatrics, 130(2), e358-e364