Do economic recessions lead to more child abuse?
That question has been hotly debated over the years, but a new study being released today by Children's Hospital of Pittsburgh and three other pediatric hospitals claims that child abuse has increased during this most recent recession.
According to the study, which involved 512 patients with abusive head trauma ranging in age from 9 days to 6 years, the number of cases rose from six on average per month before Dec. 1, 2007 to 9.3 per month after that date.
"These numbers are really concerning," said Dr. Rachel Berger, lead researcher of the study and a child abuse specialist at Children's Child Advocacy Center in Pittsburgh. "Our results show that there has been a rise in abusive head trauma, that it coincided with the economic recession, and that it's not a phenomenon related to our region but happening on a much more widespread level," she said.
When researchers first detected the upward trend in 2008, "We had to wonder if it was just us."
So they reached out to other hospitals who are the primary health care providers for children in their communities: Nationwide Children's Hospital in Columbus, Seattle Children's Hospital and Cincinnati Children's Hospital Medical Center.
She noted, however, that their data didn't show a causal link to the recession.
"We didn't confirm a link or prove an effect," she said, "but we believe there is a relationship. We saw an increase almost immediately in the beginning of 2008 that was really dramatic."
However, other child abuse experts say they haven't seen the same increases. Marc Cherna, director of Allegheny County's Department of Human Services who once headed the county's child welfare division, said its data showed no increase in head injuries in substantiated child abuse cases during the same period.
"Our abuse numbers are pretty stable," he said. "This doesn't mean it's not happening elsewhere, it's just that in Allegheny County we're not seeing an increase."
A large federal study released in February actually found a dramatic drop in incidents of serious child abuse, especially sexual abuse, in 2005-06, down 26 percent from 1993. But that was prior to the recession of 2008.
That study was hailed by experts as an indication that greater public awareness and vigilance by police, teachers, child welfare workers and other "sentinels" had had an effect.
David Finkelhor, a professor at the University of New Hampshire and a nationally known researcher in the field of child abuse, said he hadn't seen the latest study by Children's, but speculated that its findings may show that more reporting of head injuries is taking place.
"We have done an enormous amount of training and awareness-raising about abusive head trauma, so people who specialize in treating these cases might be getting more of them," Mr. Finkelhor said, "You might have doctors seeing kids who had certain kinds of symptoms, who wouldn't have thought about head trauma, but had their awareness raised."
Of the most recent Children's study, 63 percent of the patients had injuries severe enough that they had to be admitted to pediatric intensive care units, and 16 percent of them died, Dr. Berger said. While many doctors may miss subtle cases of child abuse, Children's data purposely included abusive head trauma cases that were so severe the patients had to be hospitalized.
While the first and hardest-hit victims of this latest recession were working and middle-class people laid off from their jobs, the children in this study were mostly from poor backgrounds, Dr. Berger noted, adding the "economic floor" effect may be at play here.
"Economic floor theory says you can live at a certain economic level, but once you drop below that floor" and when those social supports fall away, families are at much greater risk for child abuse.
While there is some indication that violence and abuse didn't increase that much during the early stages of the recession, it's possible that the incidence of child maltreatment has risen more recently, "but no numbers will be available for that for a long time," Mr. Finkelhor said.
Mackenzie Carpenter: firstname.lastname@example.org or 412-263-1949.