A new report released today is the first to capture the enormity of severe child abuse in America. It quantifies both the number and severity of child abuse cases in the U.S. and finds some distressing realities.

An analysis published in the journal Pediatrics reports that 4,569 children were hospitalized due to serious abuse in 2006. (PHOTODISC)

The hospitalization incidence was highest for children during the first year of life, at 58.2 per 100,000 children in this age group. (Higher than the rate of sudden infant death syndrome which is believed to be about 50 per 100,000 births.)

“Because I work in the field of child abuse, I was not surprised by the scope of the problem. Too many children, especially children less than 3 years of age, suffer serious injuries due to child abuse and are admitted to the hospital for the care of these injuries,” John M. Leventhal, an author of the report and a child abuse specialist at Yale-New Haven Hospital told me.

“The percentage of the children in the hospital who die because of abuse is very high and much higher than children admitted for other types of injuries or for medical or surgical causes.”

The findings also bolster anecdotal evidence and an earlier study on abuse that suggest the economic downturn and increased financial strain in families can lead to abuse. The earlier report, published in Pediatrics in September, found that abusive head-trauma increased in areas where unemployment spiked.

The study released this week found that poverty is a major risk factor in severe abuse. Children covered by Medicaid had rates of serious abuse about six times higher than those not on Medicaid.

Leventhal and his colleagues used data from pediatric hospitals compiled in the 2006 Kids’ Inpatient Database.

Their intent was to focus on the most severe abuse, so they only counted those children who were admitted to the hospital and whose injuries were classified as the result of abuse (as opposed to those that raised suspicions but were not classified as abuse).

Leventhal said that authors hope the new data will be a step toward designing better abuse prevention strategies. “Measuring the extent of a problem is often the first step in deciding that there is a need to address a problem, so I hope that that the pediatric and public health communities rise to the challenge and make stronger efforts to prevent these abusive behaviors.

“It is important to remember that these injuries are caused by parents and sometimes baby sitters. Men, including fathers, step-fathers and boyfriends are the most common perpetrators of serious abusive injuries so prevention programs need to address these care givers as well. These abusive injuries occur when the caregiver gets upset or frustrated with a child’s behavior, such as crying, so we need to teach all who look after young children how to respond to frustration and anger toward a child,” he said.

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