A comparison of child abuse and neglect encounters before and after school closings due to SARS-Cov-2

• Published in: Child abuse & neglect Vol. 118; p. 105132
• Main Authors: Salt, Elizabeth, Wiggins, Amanda T., Cooper, Gena L., Benner, Kalea, Adkins, Brian W., Hazelbaker, Katherine, Rayens, Mary Kay
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2021; Elsevier Science Ltd
• Subjects: Abused children; Adolescent; Age; Chi-square test; Child; Child Abuse; Child abuse & neglect; Child Abuse - psychology; Child Abuse - trends; Child Neglect; Child sexual abuse; Child, Preschool; Children; Codes; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; COVID-19 - psychology; Demographics; Emergency department; Emergency services; Ethnicity; Female; Gender; Health services; Humans; Infant; Inpatient; Inpatient care; Male; Maltreatment; Pandemics; Patients; Physical abuse; Race; Retrospective Studies; Risk Factors; SARS-CoV-2; School Closing; School closures; Schools - trends; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Sex crimes; Sexual abuse; Inpatient; Demographics; Sexual abuse; Emergency department; Physical abuse; Maltreatment
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2021.105132

Risk factors for child abuse and neglect and commonly used reporting mechanisms were highly affected by SARS-Cov-2 pandemic; yet, little is known about the effects of SARS-Cov-2 on rates of child abuse and neglect.
To compare overall rates, demographics, types of abuse and acuity of child abuse and neglect encounters seen at one university health system for the 6 months before and after school closings due to the SARS-Cov-2 pandemic.
Data was extracted from a database of billed ICD10 codes for child abuse and neglect including sexual abuse codes. There were 579 encounters for patients <18 years of age and 476 unique patients.
In addition to ICD10 code and pre/post school closing, each encounter was identified to be inpatient, outpatient and/or emergency department. Demographic data such as age, gender, ethnicity, and race were extracted. Incident rate ratios in addition to descriptive statistics, Mann-Whitney U test, two-sample t-test, or the chi-square test of association were used in the analysis.
No significant differences were identified for total rates of child abuse and neglect encounters (p = .08), physical abuse (p = .91) nor child maltreatment (p = .86) codes or in the age (p = .46), gender (p = .58), and race/ethnicity (p = .15) of patient encounters pre- versus post-school closings. The sexual abuse incidence and inpatient encounters increased by 85% (IRR = 1.85, p < .0001; IRR = 1.85, p = .004, respectively).
Our findings provide a unique contribution to the existing literature in that we identified a significant increase in the incidence of sexual abuse and higher patient acuity as evidenced by higher rates of inpatient encounters after school closing due to SARS-Cov-2.
•Overall rates, demographics and types and acuity of child abuse encounters were compared before and after the SARS-Cov-2 pandemic.•The sexual abuse incidence increased by 85% (IRR=1.85, p<.0001).•Total inpatient encounters for all types of child abuse and neglect increased by 85% (IRR=1.85, p=.004, respectively).•The increased rates of child sexual abuse after school closing due to SARS-Cov-2 are unreported in published literature.