Abstract
Objective
We aimed to examine abusive head trauma (AHT) incidence before, during and after the
recession of 2007–2009 in 3 US regions and assess the association of economic measures
with AHT incidence.
Methods
Data for children <5 years old diagnosed with AHT between January 1, 2004, and December
31, 2012, in 3 regions were linked to county-level economic data using an ecologic
time series analysis. Associations between county-level AHT rates and recession period
as well as employment growth, mortgage delinquency, and foreclosure rates were examined
using zero-inflated Poisson regression models.
Results
During the 9-year period, 712 children were diagnosed with AHT. The mean rate of AHT
per 100,000 child-years increased from 9.8 before the recession to 15.6 during the
recession before decreasing to 12.8 after the recession. The AHT rates after the recession
were higher than the rates before the recession (incidence rate ratio 1.31, P = .004) but lower than rates during the recession (incidence rate ratio 0.78, P = .005). There was no association between the AHT rate and employment growth, mortgage
delinquency rates, or foreclosure rates.
Conclusions
In the period after the recession, AHT rate was lower than during the recession period
yet higher than the level before the recession, suggesting a lingering effect of the
economic stress of the recession on maltreatment risk.
Keywords
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Article Info
Publication History
Published online: July 13, 2015
Accepted:
May 25,
2015
Received:
February 9,
2015
Footnotes
Dr Wood's institution has received payment for expert witness court testimony that Dr Wood has provided in cases of suspected child abuse for which she has been subpoenaed to testify. Dr Scribano's institution has received payment for expert witness court testimony he has provided. Dr Feldman and his institution have received payment for child abuse legal consultation he has provided. Dr Letson receives royalty payments from the University of Arizona for creation of an online course on child maltreatment. The authors declare that they have no conflict of interest.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
