Abusive Head Trauma During a Time of Increased Unemployment: A Multicenter Analysis
Rachel P. Berger,Janet Fromkin,Haley Stutz,Kathi L. Makoroff,Philip V. Scribano,Kenneth W. Feldman,Li Chuan Tu,Anthony Fabio +7 more
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TLDR
The rate of abusive head trauma increased significantly in 3 distinct geographic regions during the 19 months of an economic recession compared with the 47 months before the recession, consistent with the understanding of the effect of stress on violence.Abstract:
OBJECTIVE: To evaluate the rate of abusive head trauma (AHT) in 3 regions of the United States before and during an economic recession and assess whether there is a relationship between the rate of AHT and county-level unemployment rates. METHODS: Clinical data were collected for AHT cases diagnosed in children younger than 5 years from January 1, 2004 until June 30, 2009, by hospital-based child protection teams within 3 geographic regions. The recession was defined as December 1, 2007 through June 30, 2009. Quarterly unemployment rates were collected for every county in which an AHT case occurred. RESULTS: During the 5½-year study period, a total of 422 children were diagnosed with AHT in a 74-county region. The overall rate of AHT increased from 8.9 in 100 000 (95% confidence interval [CI]: 7.8–10.0) before the recession to 14.7 in 100 000 (95% CI: 12.5–16.9) during the recession ( P CONCLUSIONS: The rate of AHT increased significantly in 3 distinct geographic regions during the 19 months of an economic recession compared with the 47 months before the recession. 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.read more
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New Directions in Child Abuse and Neglect Research
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References
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TL;DR: Although diagnosing head trauma can be difficult in the absence of a history, it is important to consider inflicted head trauma in infants and young children presenting with nonspecific clinical signs.
Journal ArticleDOI
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Heather T. Keenan,Desmond K. Runyan,Stephen W. Marshall,Mary Alice Nocera,David F. Merten,Sara H. Sinal +5 more
TL;DR: In this population of North Carolina children, the incidence of inflicted TBI varied by characteristics of the injured children and their mothers, and these data may be helpful for informing preventive interventions.
Journal ArticleDOI
Shaken baby syndrome.
TL;DR: Examination of the comprehensive ophthalmologic experience with the shaken baby syndrome at one medical center found good initial visual reaction was highly correlated with good final vision and neurologic outcome, and a high correlation with survival.