Association between socioeconomic status and risk of hospitalization due to child maltreatment in the USA

Abstract

Child maltreatment remains a significant problem in the USA. There is a dearth of literature examining the association of socioeconomic status (SES) and incidence of child maltreatment among hospitalized children across the entire USA. Our aim was to study the association between SES and incidence and mortality from child maltreatment among hospitalized children in the USA. We used 2013–2014 data from the Nationwide Inpatient Sample, a discharge database representative of all hospitals in the USA. International Classification of Diseases-9 codes for general child maltreatment were used to identify patients discharged with a primary diagnosis of child maltreatment. Trends in the incidence and outcomes of child maltreatment were compared with SES based on quartiles (Qx) of median household income. In 2013–2014, there were a total of about 2.3 million pediatric discharges. Out of these, a total of 8985 had a primary diagnosis of child maltreatment. Approximately 40 per cent of the cases were from families with the lowest SES (Q1). In-hospital mortality was 2.4 per cent in Q1 (lowest SES) compared with 0.4 per cent in Q4 (highest SES). We conclude that children from lower SES households have a higher incidence of child maltreatment and have worse outcomes, including significantly higher in-hospital mortality among hospitalized children. This trend was generally consistent across all age groups and ethnicities. To our knowledge, this is the first report studying the association between SES and children with child maltreatment among hospitalized children across the entire USA.

Psychological stress during childhood and adolescence and its association with inflammation across the lifespan: A critical review and meta-analysis.

“…The various types of childhood adversities examined in the literature tend to co-occur, with stress-exposed youth rarely experiencing only one type of stressor (Smith & Pollak, 2020). For instance, maltreatment and peer victimization are more prevalent among socioeconomically disadvantaged families (Imran et al, 2019; Kim & Drake, 2018; Tippett & Wolke, 2014). Maltreated youth are also more likely to be bullied compared to their nonmaltreated peers (Shields & Cicchetti, 2001).…”

Intergenerational trauma: Parental PTSD and parent‐reported child abuse subtypes differentially relate to admission characteristics in the autism inpatient collection

“…A systematic review of social determinants of child maltreatment identified significant and robust links between poverty and several other socioeconomic status indicators (e.g., parental educational attainment, housing instability, food insecurity, and insurance) with heightened rates of maltreatment (Hunter & Flores, 2021). For example, youth from lower socioeconomic status households experience greater rates of maltreatment as well as more negative outcomes (Imran et al, 2019), and children living below the family poverty level experience significantly more adverse childhood experiences (Goldstein et al, 2021). Similarly, autistic youth are more likely to experience income insufficiency (Berg et al, 2016), and autistic youth from lower income households are at disproportionate risk for adverse childhood experiences (Kerns et al, 2017).…”

The importance of diversity in cognitive neuroscience

“…It should be noted that other stressors that also affect neurocognitive development, such as childhood maltreatment, may be important to consider as potential covariates of SES. While not a component of SES, maltreatment (i.e., abuse and neglect) is sometimes correlated with childhood SES . However, recent evidence has shown that they independently influence limbic volumes measured in young adults, and brain volume, cerebral blood flow, and cognitive functioning in children and young adults …”

“…While not a component of SES, maltreatment (i.e., abuse and neglect) is sometimes correlated with childhood SES. 27 However, recent evidence has shown that they independently influence limbic volumes measured in young adults, 28 and brain volume, cerebral blood flow, and cognitive functioning in children and young adults. 29 Thus, it is important that researchers consider multiple SES components within a study to separate their respective contributions to research outcomes.…”