Estimating child maltreatment cases that could be alcohol‐attributable in New Zealand

Abstract

Aims Children are an important group harmed by others' alcohol consumption. This study (1) compared the risk of occurrence of child maltreatment among children exposed versus not exposed to parents with an alcohol‐attributable hospitalization or service use for mental health/addiction and (2) conducted sensitivity analyses to estimate the cases of child maltreatment that could be attributable to alcohol under two different conditions in New Zealand. Design A cohort study conducted among children 0−17 years and their parents (years 2000–2017) using the Statistics New Zealand Integrated Data Infrastructure. The New Zealand Health Survey 2017 was also used. Setting New Zealand. Participants 58 359 children aged 0–17 years and their parents. Measurements Survival analysis based on a Bayesian piecewise exponential model was used to estimate the risk of time to first substantiated child maltreatment event (identified from social service, hospital, mortality and police data) related to exposure to parents with an alcohol‐attributable hospitalization or who used a mental health/addiction service (versus no exposure). Potential confounders were included for parents and children. The sensitivity analyses (i) estimated an alcohol‐attributable admissions/service use fraction for maltreatment in 2017 and (ii) calculated a population‐attributable fraction using the relative risk from the cohort and prevalence of hazardous drinking (AUDIT 8+) among parents in 2017. Findings There was a 65.1% [1.65; 95% confidence interval (CI) = 1.46−1.86] increased risk of child maltreatment if a child was exposed to parents who had an alcohol‐attributable hospitalized or mental health/addictions service use. The sensitivity analyses estimated that in 2017 14.6% (CI = 14.0−15.3%) and 11.4% (95% CI = 8.4−14.3%) of the documented cases of child maltreatment in New Zealand could be attributable to parents with severe or hazardous consumption. Conclusions In New Zealand, exposure to parents with an alcohol‐attributable hospitalization or service use is a risk factor for substantiated child maltreatment.

Proximity of alcohol outlets and presentation to hospital by young people after self-harm: A retrospective geospatial study using the integrated data infrastructure

“…We did not have police or ambulance call-out data for self-harm, nor community-level data regarding self-harm and how this relates to proximity to alcohol outlets. Finally, given the legal age for drinking alcohol in New Zealand is 18 and over, further research is needed to understand the association between proximity to alcohol outlets and self-harm presentation in the 15- to 19-year-old group, who despite being underage may still be accessing alcohol or may be impacted by the harms associated with the adults around them drinking ( Huckle and Romeo, 2022 ; Rossow and Moan, 2012 ).…”

Quantifying alcohol‐attributable disability‐adjusted life years to others than the drinker in Aotearoa/New Zealand: A modelling study based on administrative data

“…Quantifiable areas of alcohol's harm to others result from drinking during pregnancy, violence and traffic crashes [2]. While there is emerging evidence of the role of alcohol in the disease burden of child maltreatment [5], more causal research is needed. We are still increasing our knowledge about the burden of disease that drinkers impose on themselves, but there is limited comprehensive estimation of the burden of alcohol harm to others.…”

The burden of prenatal and early life maternal substance use among children at risk of maltreatment: A systematic review

“…Prenatal substance use has been associated with an increased risk of child maltreatment [15][16][17], child protection service referrals [15,18], OOHC placements [15,16,19] and increased child hospitalisations [20,21] and injury [22]. Prenatal substance use may, in some circumstances, impact critical development in utero, which may have later health and developmental consequences for children [23][24][25].…”