- The Washington Times - Monday, February 6, 2012

An estimated 4,500 children were so badly abused in 2006 they needed to be taken to a hospital, and 300 of them — mostly babies — died of their injuries, says a first-of-its-kind study released online Monday in the journal Pediatrics.

The study included a 3-month-old with multiple bruises, a 3-month-old with life-threatening abusive head trauma, babies with retinal hemorrhages from “shaken-baby syndrome,” as well as children of all ages who suffered burns, fractures, abdominal injuries and open wounds.

All the injuries were caused by physical abuse, according to hospital diagnostic codes, Injuries that could have happened accidentally or in nonabusive situations were excluded.

Abuse was highest among infants and children on Medicaid.

The study was designed to capture information on severe child abuse, which can’t be seen in broad national studies on child abuse, said Dr. John Leventhal, professor of pediatrics at Yale University School of Medicine and medical director of the child abuse and child abuse prevention programs at Yale-New Haven Yale Hospital.

The data should also help improve child-abuse prevention efforts.

“I run a prevention program related to child abuse,” Dr. Leventhal said, “and we are always interested [in knowing], do these prevention programs change these kinds of phenomena?”

Dr. Leventhal and his colleagues reviewed data from the 2006 Kids’ Inpatient Database, which contains information on more than 2 million pediatric hospitalizations.

The database allows cases to be searched by codes for “external cause of injury,” including those to indicate child abuse, as well as whether a patient was discharged or died. It also collects demographic and payment information.

The weighted findings were that, in 2006, 4,569 children were hospitalized for serious physical child abuse, and 300 of these children died of their injuries. The highest death rate was among infants 12 months old or younger.

The health care cost was about $74 million.

Also, poverty and severe abuse appeared linked: Hospitalizations for physical abuse were six times higher for children on Medicaid than children with other payment methods.

The Medicaid finding “really relates, I believe, to the stresses that impoverished families face in our country,” said Dr. Leventhal. “And one of those stresses is being a good parent, and not responding in an abusive way to frustrations, due to a baby’s crying or problems with toileting.”

Details about the abusers were beyond the scope of the study. However, mothers, fathers, babysitters and unrelated men who live in the child’s home, such as a boyfriend of the mother, are all capable of abuse, according to research.

“One of the challenges of prevention programs … is how to reach the men in the home,” added Dr. Leventhal.

According to the National Child Abuse and Neglect Data System for fiscal 2010, there were 695,000 unique child victims of abuse. Around 18 percent suffered physical abuse.

Separately, the Centers for Disease Control and Prevention (CDC) released a new report that found that the lifetime economic burden in the United States of one year’s worth of confirmed child maltreatment cases is $124 billion.

The study, published in Child Abuse and Neglect: the International Journal, reviewed 1,740 fatal and 579,000 nonfatal cases of child physical abuse, sexual abuse, psychological abuse, and neglect over a 12-month period.

It estimated that each child-abuse survivor would incur $210,012 in costs over their lifetime for abuse-related health care; child welfare, criminal justice, special-education services; and productivity losses. If a child-abuse victim died as a child, the costs per death were $14,000 in medical costs and $1.2 million in productivity losses, the CDC study said.

• Cheryl Wetzstein can be reached at cwetzstein@washingtontimes.com.

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