Long-term trends in child maltreatment in England and Wales, 1858–2016: an observational, time-series analysis

Abstract

Background It is unclear whether child maltreatment is increasing or decreasing in England and Wales. More evidence is needed, from multiple sources and over longer periods of time, to explore trends in child maltreatment. We investigated whether the annual incidence of child maltreatment has changed over time, using official record data and time-series methods to establish long-term trends. Methods In this observational time-series analysis, we used six data sources (Government records for child mortality, police-recorded child homicides, crimes against children, child protection, and children in care; and NSPCC data) to estimate the incidence of child maltreatment in England and Wales and examine long-term trends. We included nationally representative data that could estimate the incidence of child maltreatment for more than 25 years. Our primary outcomes were the number of victims (age <20 years) or perpetrators (age >16 years) of child maltreatment per 12-month period in England, including or excluding Wales. We fitted Poisson regression models with year as the exposure and the number of victims or perpetrators of child maltreatment as the outcome (adjusted for population age-structure and size). When a linear trend was not appropriate, we fitted generalised additive models with penalised splines to visualise trends. Findings The incidence of child mortality by homicide or assault decreased by 90% (2•7 per 100 000 children) between 1858 and 2016 and the incidence of people guilty of child cruelty or neglect decreased by 83% (6•7 per 100 000 adults) between 1893 and 2016, whereas child protection registrations increased by 182% (328•7 per 100 000 children) between 1988 and 2016. Crimes against children and children entering care increased between 2000 and 2016. In 2016, 40 children died by homicide, with twice as many adolescent (15-19 years) deaths than infant (age <1 year) deaths. In 2016, 67 700 children were placed on the child protection register and neglect and emotional abuse were the most common reasons. Interpretation Although long-term trends have decreased, child maltreatment remains a major public health problem in England and Wales. Further research is needed to establish whether adolescents are a particularly vulnerable age group and whether neglect and emotional abuse are increasing. Future child protection policies and practices should respond to these areas of growing need.

Exploration of trends in the incidence and prevalence of childhood maltreatment and domestic abuse recording in UK primary care: a retrospective cohort study using ‘the health improvement network’ database

“…The study found a decreasing long-term trend in child maltreatment until the year 2000 but reported an increase thereafter. 30 However, child mortality continued to decrease. 30 A recommendation of the report was to further research and establish whether child maltreatment is continuing to increase.…”

“…30 However, child mortality continued to decrease. 30 A recommendation of the report was to further research and establish whether child maltreatment is continuing to increase. 30 However, once again when taken from the CSEW, the estimated prevalence of experiencing childhood maltreatment was 18.9% (financial year end 2016).…”

“…30 A recommendation of the report was to further research and establish whether child maltreatment is continuing to increase. 30 However, once again when taken from the CSEW, the estimated prevalence of experiencing childhood maltreatment was 18.9% (financial year end 2016). 31 The information relating to the incidence rate (IR) for those at risk of childhood maltreatment or domestic abuse is low.…”

Administrative data and long-term trends in child maltreatment: the prospects and pitfalls

“…These strategies enable the authors to arrive at several novel findings. 5 First, fatal violence against children in England and Wales has steadily decreased for the past 150 years (90% decrease in child death by homicide or assault between 1858 and 2016); this trend is most prominent among children younger than 1 year. Second, in the 21st century, registrations with child protection services have proliferated (182% increase between 1988 and 2016), driven increasingly by neglect and emotional abuse rather than physical abuse.…”

“…As the rapid digitisation of historical data opens exciting new frontiers in research, it will be important to remember the consequences of missing data and to compare like for like when analysing trends. Through the innovative use of multiple sources of administrative data, Esposti and colleagues 5 generate some definitive conclusions about long-term decreases in severe violence against children. If their findings about trends since the turn of the century are less conclusive, their approach nevertheless charts a careful path for navigating the thorny problem of measuring trends in child abuse and neglect, a path that others should emulate.…”