Pediatricians and other health-care professionals are uniquely positioned to identify victims of domestic violence and child abuse within the same family and to offer potentially
lifesaving assistance. Among 3 million cases of child abuse reported each year in the United States, one third are substantiated, and approximately 1,200 children die as a direct result of abuse and neglect. The statistics for domestic violence victims are equally daunting.
According to the Commonwealth Fund, at least 33% of women in the United States experience domestic violence at least once in their lifetime. In the year 2000, more than 1,200 women were killed by an intimate partner. A direct connection between domestic violence and child abuse is not surprising, given that more than 50% of victims of domestic violence live in households that have children younger than 12 years of age. In 35 studies reviewed by Edelson, 50% demonstrated that domestic violence and child abuse occur together between 30% and 60% of the time.
The risk of physical abuse in children increases with the level of violence in the household. With one self-reported act of domestic violence, child abuse occurs 5% of the time. However, in households that experience 50 or ore episodes of domestic violence, nearly 100% of hildren are physically abused by their fathers and 30% by heir mothers. The converse also is true: Domestic violence occurs in 40% to 60% of households where an abused child resides, a figure far higher than the 13% overall prevalence of domestic violence.
Domestic violence also places children at increased risk of sexual abuse. One study found a 150% increase in the risk of child sexual abuse in households where domestic violence took place.
*Medical Director, Children’s Protection Center, Children’s Hospital at Montefiore, Bronx, NY.
†Director, Division of Adolescent Medicine, Department of Pediatrics, St. Barnabas Hospital, Bronx, NY.
Article psychosocial issues
Pediatrics in Review Vol.27 No.9 September 2006 339