|
 “We think our study should inform public health leaders and local
clinicians to be aware that children living in high-poverty
communities are really a vulnerable group at increased risk of death
due to child abuse,” lead author Dr. Caitlin Farrell, a pediatrician
at Boston Children’s Hospital, said in a phone interview.
Farrell and her team analyzed death certificates for young children
and U.S. Census poverty data from 1999 through 2014. For children
ages 4 and under, counties with the highest concentrations of
poverty had more than triple the rate of child-abuse fatalities
compared to counties with the lowest concentrations of poverty, the
study reported in Pediatrics found.
Nearly 10 out of every 100,000 children died as a result of child
abuse in the most impoverished counties, the study found.
African-American children were the most vulnerable regardless of
where they lived.
Among every 100,000 young children, eight African-Americans died
from assault, shaken-baby syndrome, abusive head trauma,
suffocation, strangulation or another form of child abuse, compared
to three white children, the study found.
The fatality rate for African-American children in the richest
counties was higher than the fatality rate for white children in the
poorest.
Farrell can’t explain why African-American infants and toddlers were
most at risk of dying from abuse. She called for more research and
for the development of policies and plans aimed specifically at
protecting poor children and African-American children.
During the 15 years covered by the study, 11,149 children died of
child abuse before turning 5 years old. Children under the age of 3
comprised the vast majority, or 71 percent, of the deaths, the
authors wrote.
African-American children represented a disproportionate 37 percent
of the nationwide child-abuse deaths.
“We hope our study can serve as a catalyst for researchers to
further explore the complex relationship between community poverty
and child abuse,” Farrell said. “Ultimately, this information is
needed for policymakers, public health officials and clinicians to
enact effective prevention strategies.”
In an accompanying editorial, Dr. Robert Block said the study’s
findings should come as no surprise.
[to top of second column] |
“What may be surprising is that although this fact is both intuitive
and now statistically proven, given the significant percentage of
children living in poverty, the United States has yet to develop a
comprehensive plan to address the issue,” he wrote. Block, who was
not involved with the study, is a past president of the American
Academy of Pediatrics and emeritus professor at the University of
Oklahoma - Tulsa University School of Community Medicine in Tulsa.
Poverty-related factors - such as food insecurity, unemployment and
living in unsafe neighborhoods with a high prevalence of gun
violence - can lead to frustrations and consequent stressors that
can lead to child abuse, Block wrote.
Parenting education could help, as could educating community leaders
to address the challenges of poverty in an effort to reduce
frustration, drug addiction, family violence and other stresses, he
wrote.
“To change the influence of poverty and race on the incidence of
child-abuse deaths will not be easy,” Block said in an email. “Early
identification of troubled parents as part of comprehensive
pediatric evaluations might be a beginning.”
Farrell also called for more preventive measures during children’s
wellness checks in pediatric clinics.
One limitation of the study is that it could not tease out pockets
of poverty within affluent counties or pockets of wealth within poor
counties. The study also could not detect possible bias on the part
of the medical examiner in determining the cause of death.
SOURCE: http://bit.ly/2pYx9Bf and http://bit.ly/2pYLQnL Pediatrics,
online April 24, 2017.
[© 2017 Thomson Reuters. All rights
reserved.] Copyright 2017 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed. |
