According to a review there has been no clear evidence of child maltreatment decreasing in the USA, England, New Zealand, Western Australia (Australia), Manitoba (Canada) and Sweden, even though decades of policies have been developed in order to achieve a reduction. The article is written by Professor Ruth Gilbert, UK Medical Research Council (MRC) Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, UK, and colleagues across these 6 countries.
The researchers discovered that in most of these countries, after the mid-1990s, the prevalence of maltreatment-related injuries and violent deaths remained stable. Manitoba and Sweden were the only nations to show decreases in violent deaths that accompany decreases in hospitalizations associated to maltreatment-related injury. Across the six countries, officially-recognized neglect or physical abuse primarily remained stable. However, other signs of of agency notification, place in-of-home care, or investigation rose, especially in young children.
According to the researchers, lower levels of maltreatment indices in Sweden than in the USA are consistent with parental risk factors, lower rates of child poverty, and policies providing greater levels of universal support for parenting in Sweden. Maltreatment-related data from 2004-2006 revealed that in the USA violent deaths were five times higher than in Sweden or Australia, which had the lowest rates. Although, little variation was observed between nations in the rate of officially-recognized physical abuse and maltreatment-related injury hospitalizations. In the USA and New Zealand child protection investigations were significantly more prevalent (1 in every 20 children, and 1 in 25 children, respectively) compared with Western Australia (1 in 170). In addition, placement in out-of-home care was ten fold higher in Manitoba than in Sweden, (3% of infants placed outside their homes each year). Rates for infants in the USA (0.6%), England (0.7%) and New Zealand (0.6%), were approximately two times as high as in Sweden (0.3%) or Western Australia (0.3%).
Although these examinations revealed a small and not considerably significant rise in England, subsequent data from the UK Department of Education revealed that between 2009 and 2010 there was a 9% increase in rates of infants placed outside of their homes. The study discovered clear evidence of increases in rates of infants placed outside of their homes in Western Australia (2% per year since the mid-1990s for children aged over 1 year), the USA (4% per year for children 1+), and Sweden (increased 3% per year for infants).
The researchers explain: “We argue for improved research to underpin these very expensive policies that profoundly affect the lives of substantial minority of children in our countries. Most Urgent, in view of increases in out-of-home care, is the need for high-quality, randomized controlled trials to assess the effectiveness of this intervention.”
Professor Gilbert states: “We would urge caution in the interpretation of these results, as there could be a number of explanations for this. Small changes may be occurring but could not be detected by the study.
For too long, policy has been driven by high profile deaths of individual children. We need to invest in population-based studies to inform policy. We also need to be able to link health and social care data to understand which professionals are seeing these children in order to improve coordination of services. Such linkage is done in Western Australia and Manitoba, where it is proving to be an important tool for child health policy.”
Written by: Petra Rattue