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Correlation of Social Vulnerability With Child Physical Abuse at an Urban Level 1 Trauma Center

Shengqing Wang1, Marinda Scrushy1, Laura Purcell1

  • 1Division of Pediatric Surgery, Department of Surgery, UT Southwestern Medical Center, Dallas, Texas.

The Journal of Surgical Research
|October 25, 2025
PubMed

Insights

Children in socially vulnerable areas face higher risks of nonaccidental trauma (NAT). This risk increased significantly during the COVID-19 pandemic, particularly concerning housing and transportation factors.

Area of Science:

  • Public Health
  • Pediatric Trauma
  • Social Epidemiology

Background:

  • Child physical abuse, or nonaccidental trauma (NAT), is a significant cause of child fatalities in the U.S.
  • Injury prevention efforts targeting NAT are crucial.
  • Understanding the link between social vulnerability and NAT rates is essential for targeted interventions.

Purpose of the Study:

  • To investigate the relationship between social vulnerability and the incidence of child physical abuse.
  • To analyze how social vulnerability impacts NAT rates in communities surrounding a pediatric trauma center.

Main Methods:

  • Retrospective cohort study utilizing trauma registry data (2015-2022).
  • Social Vulnerability Index (SVI) from CDC data was used to define social vulnerability.
  • Statistical analyses (chi-square, Kruskal-Wallis, logistic regression) compared SVI between NAT-evaluated and non-NAT-evaluated patients.

Main Results:

  • Patients in the highest SVI quartile showed a higher likelihood of NAT investigation (P < 0.001).
  • High SVI was associated with a 28.6% relative increase in NAT odds during the pandemic.
  • All SVI themes were linked to NAT, with housing and transportation being the most predictive factors.

Conclusions:

  • Children in socially vulnerable communities are at an elevated risk for NAT.
  • Pandemic-related measures exacerbated the association between social vulnerability and NAT.
  • Findings highlight the need for community-level support and targeted prevention strategies for vulnerable populations.
Abstract

Keywords:
Child physical abuseInjury preventionNonaccidental trauma (NAT)Social vulnerability index (SVI)Socioeconomic determinants

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