1
|
Green MJ, Watkeys OJ, Harris F, O'Hare K, Whitten T, Tzoumakis S, Laurens KR, Carpendale EJ, Dean K, Carr VJ. Cohort Profile Update: The New South Wales Child Development Study (NSW-CDS) - Wave 3 (child age ∼18 years). Int J Epidemiol 2024; 53:dyae069. [PMID: 38796754 DOI: 10.1093/ije/dyae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 05/02/2024] [Indexed: 05/28/2024] Open
Affiliation(s)
- Melissa J Green
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Oliver J Watkeys
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Felicity Harris
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Kirstie O'Hare
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Tyson Whitten
- Centre for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Stacy Tzoumakis
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Criminology and Criminal Justice, Griffith University, Southport, QLD, Australia
| | - Kristin R Laurens
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Emma J Carpendale
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Kimberlie Dean
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
| | - Vaughan J Carr
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
2
|
Milidou I, Merrild CH, Frost L, Charles AV, Kjeldsen HC, Søndergaard C. Suspicion of child maltreatment: Knowledge and experiences with mandatory reports to social services among general practitioners in Denmark in 2019-20. CHILD ABUSE & NEGLECT 2023; 139:106132. [PMID: 36924625 DOI: 10.1016/j.chiabu.2023.106132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 02/22/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Child maltreatment has many consequences through the lifespan. The general practitioners (GPs) are in longitudinal contact with the family and can play an important role in identifying children in danger and reporting to the social services. OBJECTIVE To explore how GPs manage suspicions of child maltreatment and to investigate potential demographic and geographic differences in reporting practices among Danish GPs. PARTICIPANTS AND SETTING All registered GPs in Denmark retrieved from Medcom, a state-financed non-profit organization. METHODS We mailed a questionnaire to all registered GPs with demographics, experiences, knowledge, and attitudes in the context of child maltreatment. RESULTS We received 1252 completed questionnaires (response rate: 38 %). Most of the participants had suspected child maltreatment during their professional life (90 %) and had made a mandatory report (85 %). More than half had received feedback after the report (56 %) and said that their report led to action (56 %). Most GPs reported feeling confident in dealing with child maltreatment (79 %) and being willing to get involved in case of suspicion (8.9 on a 0-10 scale). We observed no geographical differences in reporting neither across the Danish regions nor among rural and urban practices, but GPs working in single practices made fewer reports to the social services. CONCLUSIONS Participant GPs in this study are aware of their role in child protection, have experiences with mandatory reports, and are willing to get involved. Possible areas for attention include collaboration and support between different settings, especially between GP practice, hospitals, justice sector, and social services.
Collapse
Affiliation(s)
- Ioanna Milidou
- Department of Pediatrics and Adolescent Medicine, Gødstrup Hospital, Hospitalsparken 15, 7400 Herning, Denmark.
| | | | - Lise Frost
- Department of Forensic Medicine, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Aarhus University, Denmark
| | - Annie Vesterby Charles
- Department of Forensic Medicine, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Aarhus University, Denmark
| | | | - Charlotte Søndergaard
- Department of Pediatrics and Adolescent Medicine, Gødstrup Hospital, Hospitalsparken 15, 7400 Herning, Denmark
| |
Collapse
|
3
|
Roper L, He VY, Perez-Concha O, Guthridge S. Complex early childhood experiences: Characteristics of Northern Territory children across health, education and child protection data. PLoS One 2023; 18:e0280648. [PMID: 36656893 PMCID: PMC9851518 DOI: 10.1371/journal.pone.0280648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
Early identification of vulnerable children to protect them from harm and support them in achieving their long-term potential is a community priority. This is particularly important in the Northern Territory (NT) of Australia, where Aboriginal children are about 40% of all children, and for whom the trauma and disadvantage experienced by Aboriginal Australians has ongoing intergenerational impacts. Given that shared social determinants influence child outcomes across the domains of health, education and welfare, there is growing interest in collaborative interventions that simultaneously respond to outcomes in all domains. There is increasing recognition that many children receive services from multiple NT government agencies, however there is limited understanding of the pattern and scale of overlap of these services. In this paper, NT health, education, child protection and perinatal datasets have been linked for the first time. The records of 8,267 children born in the NT in 2006-2009 were analysed using a person-centred analytic approach. Unsupervised machine learning techniques were used to discover clusters of NT children who experience different patterns of risk. Modelling revealed four or five distinct clusters including a cluster of children who are predominantly ill and experience some neglect, a cluster who predominantly experience abuse and a cluster who predominantly experience neglect. These three, high risk clusters all have low school attendance and together comprise 10-15% of the population. There is a large group of thriving children, with low health needs, high school attendance and low CPS contact. Finally, an unexpected cluster is a modestly sized group of non-attendees, mostly Aboriginal children, who have low school attendance but are otherwise thriving. The high risk groups experience vulnerability in all three domains of health, education and child protection, supporting the need for a flexible, rather than strictly differentiated response. Interagency cooperation would be valuable to provide a suitably collective and coordinated response for the most vulnerable children.
Collapse
Affiliation(s)
- Lucinda Roper
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Vincent Yaofeng He
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Oscar Perez-Concha
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Steven Guthridge
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| |
Collapse
|
4
|
Gnanamanickam ES, Brown DS, Armfield JM, Segal L. Excess hospital costs incurred by individuals with child abuse and neglect history in South Australia: A birth-cohort study. Prev Med 2023; 166:107378. [PMID: 36493867 DOI: 10.1016/j.ypmed.2022.107378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 11/20/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Child abuse and neglect is a serious public health issue across the globe, with documented impacts on health, but the impact on hospital costs, at the population level, is unknown. We aimed to estimate the additional public hospital costs for emergency department visits and admitted patient hospitalizations, for persons with reported child protection concerns, from birth to 31 years and modelled to age 65. Using linked hospital data from 2003 to 2017 for a population birth-cohort of all individuals born in South Australia from 1986 to 2017, we estimated costs of public hospital care. Mean cost and cost differences (adjusted and unadjusted) in 2018 Australian dollars (AU$) were calculated for persons with child protection contact vs none, per person and at the population level. Persons with child protection contact had higher annualized mean hospital costs than those with no contact, with cost differentials increasing with age. Unadjusted differential cost per person was AU$338 (95% CI AU$204-AU$473) from birth to 12 years; increasing to AU$2242 (AU$2074-AU$2411) at ages 25 to 31 years, equating to an additional AU$124 (US$100) million for public hospital services from birth to 31 years, an 18% cost penalty (33% from 13 to 31 years). Modelled to age 65 years, excess costs were estimated at AU$415 (US$337, adjusted: AU$365 and US$296) million, a 27% cost impost. There is a considerable hospital cost penalty associated with persons with reported child protection concerns, especially from adolescence into adulthood, highlighting an opportunity for cost savings by preventive investment in effective early-in-life interventions.
Collapse
Affiliation(s)
| | - Derek S Brown
- Institute for Public Health, Washington University in St. Louis, St. Louis, USA
| | - Jason M Armfield
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Leonie Segal
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| |
Collapse
|
5
|
Neil AL, Chappell K, Wagg F, Miller A, Judd F. The Tasmanian Conception to Community (C2C) Study Database 2008-09 to 2013-14: Using linked health administrative data to address each piece in the puzzle. Soc Sci Med 2021; 284:114216. [PMID: 34274707 DOI: 10.1016/j.socscimed.2021.114216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/31/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Tasmania, Australia has a small widely dispersed regional and rural population. The Conception to Community (C2C) Study Database was established as a research platform to inform service planning and policy development and improve health outcomes for Tasmanian mothers and children. The aims of this study were to establish by maternal socio-demographic characteristics: 1) the distribution of births in Tasmania; 2) hospital utilisation for children from birth to 5-years; and 3) the association between child and maternal emergency department (ED) presentation rates. METHODS Perinatal and public hospital ED and admitted patient data were linked for every child born in Tasmania between 2008-09 to 2013-14, and their mothers. Individualised rates of ED presentations and hospital admissions were calculated from birth to 5-years. Frequent presenters to ED were defined as having at least four presentations per annum. Ratios of ED presentation and hospital admission rates by sociodemographic characteristics (region (north, north-west, south), rurality, maternal age, and area socioeconomic disadvantage) were estimated using mixed-effects negative binomial models, with random intercepts for each child and family. RESULTS The C2C Database is comprised of records for 37,041 children and 27,532 mothers. One-in-ten Tasmanian babies lived in a remote area. The mean yearly rate of ED presentations per child varied by sex, age, region and rurality. Frequent presenters were more likely to reside in the north-west or north, in urban areas, have mothers under 20- years, be male, and live in more disadvantaged areas, with 2.3% of children frequent presenters in their first year of life. The odds of a child being a frequent presenter during their first-year was 6.1- times higher if the mother was a frequent presenter during this period. CONCLUSION Associations between maternal and child health service use and combined effects of regionality and rurality highlight opportunities for targeted intervention and service innovations.
Collapse
Affiliation(s)
- Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - Kate Chappell
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Fiona Wagg
- Child and Adolescent Mental Health Services South, Tasmanian Health Service, Hobart, Australia
| | - April Miller
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Fiona Judd
- Menzies Institute for Medical Research, University of Tasmania, Australia; Perinatal and Infant Mental Health Team, CAMHS South, Tasmanian Health Service, Hobart, Australia
| |
Collapse
|