ABSTRACT
We use high-frequency mobile phone movement data and quick-release administrative data from Georgia to examine how time at home during the COVID-19 pandemic is related to child maltreatment referrals. Findings show that referrals plummeted by 58% relative to previous years, driven by fewer referrals from education personnel. After this initial decline, however, each 15 minutes at home was associated with an increase in referrals of material neglect by 3.5% and supervisory neglect by 1%. Our results describe how children have fared during the initial wave of the pandemic, and the results have long-term implications for child development and well-being.
ABSTRACT
BACKGROUND: The ongoing worldwide COVID-19 pandemic has heightened several risk factors for child abuse and neglect (CAN). We study whether COVID-19 and the public health response to it affected CAN-related pediatric emergency department (ED) visits in the southeastern United States (US). METHODS: We performed a retrospective chart review on medical records of ED visits from a level I pediatric hospital system serving one of the largest metropolitan areas in the southeastern US from January through June 2018-2020. We used multivariate Poisson regression and linear regression to compare professionally identified CAN-related ED visits before and after a COVID-19 public health emergency declaration in 2020, relative to trends over the same period in 2018 and 2019. RESULTS: Although the number of both overall pediatric ED visits and CAN-related ED visits declined, the number of CAN-related ED visits due to neglect from inadequate adult supervision increased by 62 % (p < 0.01). The number of CAN visits per 1,000 pediatric ED visits also increased by 97 % (p < 0.01). Finally, the proportion of CAN-related ED visits due to neglect from inadequate supervision increased by 100 % (p < 0.01). CONCLUSIONS: Physicians should be aware that patients who present with injuries during a pandemic may be victims of neglect due to changes in social structures in their households. In particular, maltreatment presenting to the ED shifted toward treating injuries and abuse resulting from inadequate supervision. Policymakers should consider the impacts of stay-at-home orders on child well-being when determining appropriate public health responses in the midst of a pandemic. TRIAL REGISTRATION: Not applicable.