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Child maltreatment and emergency department visits: a longitudinal birth cohort study from infancy to early adulthood

Emmanuel S Gnanamanickam1, Ha Nguyen2, Jason M Armfield1

  • 1Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia.

Child Abuse & Neglect
|November 25, 2021
PubMed

Insights

Child maltreatment (CM) significantly increases emergency department (ED) visits throughout life, particularly for mental health and injury-related concerns. These findings underscore the urgent need for prevention strategies to address the long-term health impacts of CM.

Area of Science:

  • Public Health
  • Epidemiology
  • Child Welfare

Background:

  • Child maltreatment (CM) is a critical global public health issue with profound health consequences.
  • Understanding the long-term health service utilization of CM victims is essential for effective intervention.

Purpose of the Study:

  • To investigate the association between varying levels of child maltreatment concern and emergency department (ED) visits from infancy to early adulthood.
  • To quantify the frequency and rate ratios of all-cause and cause-specific ED visits in relation to CM severity.

Main Methods:

  • Utilized linked administrative data for a large cohort of individuals born in South Australia (N=443,754) between 1986 and 2017.
  • Examined cumulative mean ED visits and adjusted rate ratios for ED visits across different age groups (childhood, adolescence, young adulthood).
  • Analyzed specific ED visit codes including self-harm, poisoning, injuries, substance use, and mental illness.

Main Results:

  • Individuals with any CM concern had substantially higher cumulative mean ED visits by age 14.5 (10.2-14.8) compared to those without (6.4).
  • Adjusted rate ratios for ED visits increased with age and CM severity, ranging from 1.26-1.54 in children to 2.22-4.34 in young adults.
  • ED visits for self-harm, substance use, and mental illness were disproportionately high (3-15 times) among those with CM concern.

Conclusions:

  • Child maltreatment is associated with significantly elevated emergency department utilization across the lifespan.
  • The heightened rates of visits for mental health, self-harm, and substance use highlight the persistent needs of CM survivors.
  • These findings emphasize the critical importance of implementing robust child maltreatment prevention programs.
Abstract

Keywords:
Child maltreatmentChild protectionEmergency service useMental health

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