- Associated Press - Monday, September 19, 2011

CHICAGO — An increase in child abuse, mostly involving infants, is linked with the recent recession in new research that raises fresh concerns about the impact of the nation’s economic woes.

The results are in a study of 422 abused children from mostly lower-income families, known to face greater risks for being abused, in just 74 counties in four states. But lead author, Dr. Rachel Berger of Children’s Hospital of Pittsburgh, said the results confirm anecdotal reports from many pediatricians who have seen increasing numbers of shaken-baby cases and other forms of brain-injuring abuse.

Dr. Berger decided to study this type of injury, known as abusive head trauma, after noticing an increase at her own hospital from late 2007 through June 2009. Her hospital averaged 30 cases per year during those recession years compared to 17 yearly before 2007.

Though this abuse is still uncommon, the number of cases in the counties studied increased sharply, rising from about nine cases per 100,000 children in prerecession years, to almost 15 per 100,000 during the recession, a 65 percent increase.


By contrast, juvenile diabetes a better-known condition affects about 19 per 100,000 children younger than 10.

Children studied were younger than 5, and most were infants. Most suffered brain damage and 69 died, though the death rate didn’t rise during the recession.

Unemployment rates in the 74 counties rose during the five-year study. The proportion of children on Medicaid in those counties also increased, from 77 percent before the recession to 83 percent. However, insurance and family employment information were not reported for the abused children in the study.

Combine the stress of raising a young child with wage cuts or lost jobs and you get “a sort of toxic brew in terms of thinking about possible physical violence,” said Mark Rank, a social welfare professor at Washington University in St. Louis. He said the study echoes sociological research linking violence with declines in economic well-being.

Along with U.S. Census data released last week indicating that a record 46 million Americans are poor, the study shows that “as poverty goes up and economic stagnation continues there are really human costs involved,” Mr. Rank said.

The study was released online Monday in the journal Pediatrics.

The counties studied were in western Pennsylvania, including Pittsburgh; central and southern Ohio; and a handful of counties in northern Kentucky and in the Seattle area. The researchers examined medical records and national labor statistics for 2004 through November 2007 and compared them with data from the recession.

Of the 422 children diagnosed with abusive head trauma during the study, roughly 65 cases occurred each year before the recession, compared to about 108 yearly during the recession.

Federal government data suggest that the recession did not affect child abuse rates. But the study authors said those numbers are based on reports from child protective services, not medical diagnoses, and did not address brain injuries specifically.

The research doesn’t prove that the recession caused the abuse. Studying different regions and children from more middle-class families would help clarify if the recession really played a role, said Dr. Peter Sherman, director of the residency program in social pediatrics at Montefiore Medical Center in New York.

Sherman noted that most children studied were publicly insured even before the recession, suggesting that their families were already struggling financially.

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