142nd APHA Annual Meeting and Exposition

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310191
Child maltreatment and health service use in two different social contexts

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Shakira Suglia, ScD, MS , Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
Ayana April-Sanders, MPH , Epidemiology, Columbia University, New York, NY
Sa Shen, PhD , University of Illinois, Champaign, IL
Alwyn T. Cohall, MD , Harlem Health Promotion Center, Columbia University, New York, NY
Glorisa Canino, PhD , University of Puerto Rico, San Juan, PR
Jocelyn Brown, MD , Columbia University, New York, NY
Cristiane Duarte, PhD , NYSPI/Columbia University, New York, NY
Background: Adults who experience abuse as children have a higher use of medical health services in adulthood compared to those not abused. However, among children, those who experience abuse have lower immunization rates and are less likely to have a primary care provider. We examined the relation between child abuse and health service use among Puerto Rican children.

Methods: Parents and children participating in the Boricua Youth Study, a longitudinal study of Puerto Rican youth residing in the Bronx, NY (N=1116) and San Juan, Puerto Rico (N=1339) completed reports of child physical, sexual and emotional abuse. Parents reported if the child had visited a doctor, hospital or clinic because the child was ill, was injured or for routine care.

Results: Mean age was 9 years and 51% were boys, 26% of children in NY reported abuse vs. 23% in PR. Models were stratified by site and adjusted for sociodemographic factors. In PR, children who experienced one type of abuse (OR 1.6 95% CI 1.1, 2.3) or two or more (OR 1.9 95%CI 1.1, 3.2) were more likely to report an injury visit. In the Bronx, children who experienced two or more types (OR 2.0 95%CI 1.1, 3.6) were more likely to report an illness visit. No relation between child abuse and routine service use was noted in either site.

Conclusion: Whether for illness or injury, children who experience abuse, frequently come in contact with health care providers, presenting opportunities for intervention and the prevention of further abuse.

Learning Areas:

Diversity and culture
Epidemiology
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the prevalence of health service use among children who experience maltreatment. Compare the prevalence of service utilization by type of service use. Discuss contextual differences on the use of services among abused children.

Keyword(s): Child Abuse

Presenting author's disclosure statement:

Not Answered