The number of children under the age of five who were physically abused and were admitted to hospital with severe brain injuries rose when the unemployment rate in the USA increased, researchers reported in the journal Pediatrics. The authors based their findings on data gathered from hospitals in Washington, Pennsylvania, Kentucky and Ohio – all the children in this study were under the age of five years.

Dr. Rachel P. Berger, a child abuse expert at Children’s Hospital of Pittsburgh, and experts from other hospitals set out to determine what the AHT (abusive head trauma) rates in 3 US regions were before the economic recession and during it – they specifically wanted to find out whether there is a link between AHT rates and county-level unemployment rates.

They gathered clinical data on AHT cases in children less than 5 years of age from January 2004 to June 2009. They defined the recession as the period between December 1, 2007 to June 30, 2009. Where AHT cases had occurred, they gathered details on unemployment rates in each county every quarter.

There were 422 children diagnosed with AHT in 74 counties during the five-year period of the study. The overall AHT rate rose from 8.9 per 100,000 before the economy slumped, to 14.7 per 100,000 during the recession. There were approximately 65 cases per year before the recession, and about 108 annually during it.

Signs and symptoms detected in the patients were similar in both pre-recession and recession periods, the authors added.

When comparing 47 months before the recession with 19 months of an economic recession, there was a significant increase in AHT rates in 3 distinct geographical regions.

The authors concluded:

“This finding is consistent with our understanding of the effect of stress on violence. Given the high morbidity and mortality rates for children with AHT, these results are concerning and suggest that prevention efforts might need to be increased significantly during times of economic hardship.”

Unemployment rates rose in all 74 countries during the recession. The percentage of children on Medicaid also rose, from 77% pre-recession to 83% during it. There is no data on insurance information for the abused children in the study.

Experts say the high rate of publicly insured children before the recession means the sample studied involved children from families who were already struggling. Therefore, the data may be biased towards lower-income groups.

Written by Christian Nordqvist