Child Maltreatment in High Income Countries (1)

Last year the British medical journal The Lancet published a major review of published research (172 references) on child abuse in developed countries (1).  The authors were a multi-national team led by Prof Ruth Gilbert of the Institute of Child Health in London.  They point out that statistics in this field are subject to significant problems since most cases are not reported when they occur and later recall by survivors may be inaccurate.  These issues result in a range of estimates for prevalence but nevertheless it is clear that child maltreatment is common with major implications for public health.

Studies using self or parent reports from the U.S., western Europe and New Zealand found rates of severe physical abuse of 4-16% per year and a 5-35% cumulative prevalence (full childhood).  For penetrative sexual abuse the cumulative prevalence was 5-10% for girls, 1-5% for boys (for any sexual abuse the rates were 15-30% and 5-15% for girls and boys respectively).  For psychological abuse, 4-9%.  For neglect, 6-12%.  For witnessing intimate partner violence, 8-25%.  Corresponding figures, where available, for eastern European countries, were often significantly higher.

The figures from investigation by social service agencies strongly suggest failure to detect abuse since less than 5% of children were investigated in both the US and the UK.  In the US, abuse or neglect was confirmed in only 1.2% of children.

The Lancet paper also reviews research into the long-term consequences of childhood maltreatment, about which more in my next post.

1. Gilbert R et al.  Burden and consequences of child maltreatment in high-income countries.  Lancet 373, Issue 9657, 3 January 2009-9 January 2009, Pages 68-81.