Local macroeconomic trends and hospital admissions for child abuse, 2000-2009.

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.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Wood JN,Medina SP,Feudtner C,Luan X,Localio R,Fieldston ES,Rubin DM

doi

10.1542/peds.2011-3755

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

e358-64

issue

2

eissn

0031-4005

issn

1098-4275

pii

peds.2011-3755

journal_volume

130

pub_type

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