When kids get medical care because of violence exposure

Tragically, for some children and adolescents, exposure to assault is all too common, and, unsurprisingly, is linked to poorer physical and mental outcomes. An investigation in JAMA Network Open examined how often children and teenagers get medical care because of exposure to assault, abuse, or violence.¹

The investigators used a representative sample of children and teenagers aged 2 to 17 years, from 2 waves (2011 and 2014) of the National Survey of Children Exposed to Violence. Caregivers of children aged younger than 10 years were interviewed over the phone. Children and adolescents aged 10 to 17 years were interviewed directly. The 53-item Juvenile Victimization Questionnaire was used to evaluate violence exposure and included follow-up questions that asked if the children were taken “to the hospital, a doctor’s office, or some kind of health clinic because of what happened.” The Trauma Symptom Checklist and the Trauma Symptom Checklist for Young Children were used to ask about lifetime and past-year childhood adverse experiences as well as current trauma symptoms.

There were 5187 children and teenagers who reported a lifetime violence exposure: 45.6% (95% CI, 43.1%-48.2%) were aged 2 to 9 years, and 54.4% (95% CI, 51.8%-56.9%) were aged 10 to 17 years. Roughly 3 percent of the sample had a violence-related medical visit at some point in their life. Rate of past-year medical visits because of violence exposure was 1.9% (95% CI, 1.2%-2.7%), which is equivalence to a point estimate of approximately 1.4 million children and teenagers. Children aged 2 to 9 years made up 33.3% (95% CI, 23.1%-45.4%) of the past-year medical visits. Children with a past-year visit had multiple violence exposures (risk ratio, 3.91; 95% CI, 3.22-4.76), higher levels of adverse childhood experiences (risk ratio, 2.55; 95% CI, 2.34-2.78), and higher levels of trauma symptoms (risk ratio, 1.71; 95% CI, 1.44-2.03) when compared to a general sample.

The investigators concluded that the large number of visits because of violence pose a chance to address the source of frequent injury, offer counseling, and refer as needed. This opportunity could help prevent further physical, mental, and social consequences.

Reference

1. Finkelhor D, Turner H, LaSelva D. Medical treatment following violence exposure in a national sample of children and youth. JAMA Netw Open. 2021;4(5):e219250. doi:10.1001/jamanetworkopen.2021.9250