Non-accidental head injury: a consequence of deprivation?

Abstract

In Scotland, children who present with suspected NAHI originate predominantly from the most deprived areas of the community. Public health and intervention strategies should be focused in these areas.

Abusive head trauma in young children in the Netherlands: evidence for multiple incidents of abuse

“…We found that in the vast majority of cases, there is evidence for multiple incidents of abuse. This is in line with prior studies that describe AHT as mainly a problem in groups of parents with very low education, often known to child welfare authorities (2,(8)(9)(10)(11).…”

“…The results of our study show that this Dutch cohort of AHT victims resembles other cohorts that have been described on demographic characteristics, outcome (1-5) and most of the social risk factors (2,(8)(9)(10)(11)(12). We found that in the vast majority of cases, there is evidence for multiple incidents of abuse.…”

“…Due to its variable presentations and nonreliable clinical history, AHT is frequently missed by physicians (6). Studies have described clinical features and radiological findings associated with AHT (7), but social risk factors have been identified for AHT as well (Table S1) (2,(8)(9)(10)(11)(12). Several studies found that there are multiple incidents of abuse in families in which AHT occurs (11,(13)(14)(15).…”

Non‐Sexual Abuse in Children

“…Similar differences are found for each of the component domains of income, employment, health, education, crime and housing (P < 0.001). In contrast, the scores for 'geographic access (to essential service)' are higher than for the whole population (P < 0.001), indicating that the deprivation is not due to a lack of local services (Minns et al 2008;Mok et al 2010) (Fig. 37.1).…”

“…Age <1 year, 29.7 (CI 22.9-36.7) Age >1 year, 3.8 (CI 1.3-6.4) Boys > girls (incidence rate) 21 vs 13 Parent in the military (ITBI vs TBI) OR 3.6 (C.I >0.9-20.8) Hobbs et al 2005 SDH/E from NAHI from lower socioeconomic group than those with SDH/E from other causes, using a Townsend score P = 0.007 Mok et al 2010 Mothers younger, 22.8 years ± 6.0 vs 28.8 years P < 0.001 Twin births in NAHI, 8%, compared with prevalence of twins in the general population of Scotland, 1.56%…”