Child maltreatment and health service use : Findings of the Australian Child Maltreatment Study

Journal article

Pacella, Rosana, Nation, Alexandra, Mathews, Ben, Scott, James G., Higgins, Daryl J., Haslam, Divna M., Dunne, Michael P., Finkelhor, David, Meinck, Franziska, Erskine, Holly E., Thomas, Hannah J., Malacova, Eva, Lawrence, David M. and Monks, Claire. (2023). Child maltreatment and health service use : Findings of the Australian Child Maltreatment Study. Medical Journal of Australia. 218(S6), pp. S40-S46. https://doi.org/10.5694/mja2.51892

Publication dates
Authors	Pacella, Rosana, Nation, Alexandra, Mathews, Ben, Scott, James G., Higgins, Daryl J., Haslam, Divna M., Dunne, Michael P., Finkelhor, David, Meinck, Franziska, Erskine, Holly E., Thomas, Hannah J., Malacova, Eva, Lawrence, David M. and Monks, Claire
Abstract	Objectives To examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported. Design, setting Cross-sectional, retrospective survey using the Juvenile Victimization Questionnaire-R2: Adapted Version (Australian Child Maltreatment Study); computer-assisted mobile telephone interviews using random digit dialling, Australia, 9 April – 11 October 2021. Participants Australians aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16–24 years and 1000 respondents each from the five age groups (25–34, 35–44, 45–54, 55–64, 65 years or more). Main outcome measures Self-reported health service use during the past twelve months: hospital admissions, length of stay, and reasons for admission; and numbers of consultations with health care professionals, overall and by type. Associations between maltreatment and health service use are reported as odds ratios adjusted for age group, gender, socio-economic status, financial hardship (childhood and current), and geographic remoteness. Results A total of 8503 participants completed the survey. Respondents who had experienced child maltreatment were significantly more likely than those who had not to report a hospital admission during the preceding twelve months (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.16–1.66), particularly admission with a mental disorder (aOR, 2.4; 95% CI, 1.03–5.6). The likelihood of six or more visits to general practitioners (aOR, 2.37; 95% CI, 1.87–3.02) or of a consultation with a mental health nurse (aOR, 2.67; 95% CI, 1.75–4.06), psychologist (aOR, 2.40; 95% CI, 2.00–2.88), or psychiatrist (aOR, 3.02; 95% CI, 2.25–4.04) were each higher for people who reported maltreatment during childhood. People who reported three or more maltreatment types were generally most likely to report greater health service use. Conclusions Child maltreatment has a major impact on health service use. Early, targeted interventions are vital, not only for supporting children directly, but also for their longer term wellbeing and reducing their health system use throughout life.
Keywords	child welfare; community health services; cost of illness; health services
Year	2023
Journal	Medical Journal of Australia
Journal citation	218 (S6), pp. S40-S46
Publisher	John Wiley & Sons Australia, Ltd
ISSN	0025-729X
Digital Object Identifier (DOI)	https://doi.org/10.5694/mja2.51892
PubMed ID	37004185
Scopus EID	2-s2.0-85151318064
Open access	Published as ‘gold’ (paid) open access
Page range	S40-S46
Funder	National Health and Medical Research Council (NHMRC)
	Department of the Prime Minister and Cabinet, Australian Government
	Department of Social Services, Australian Government
	Australian Institute of Criminology
	European Research Council (ERC)
	UK Research and Innovation Global Challenges Research Fund
	Department of Health, Queensland Government
Publisher's version	OA_Pacella_2023_Child_maltreatment_and_health_service_use.pdf License CC BY 4.0 File Access Level Open
Output status	Published
Online	02 Apr 2023
Publication process dates
Accepted	23 Jan 2023
Deposited	18 Jul 2023
Grant ID	1158750
	ES/S008101/1
	852787
	1137969

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Protecting children from abuse in organisations needs leadership and cultural change

Higgins, Daryl J.. (2017). Protecting children from abuse in organisations needs leadership and cultural change The Conversation Media Group. https://doi.org/10.24268/fhs.8341

Adverse childhood experiences, non-response and loss to follow-up: Findings from a prospective birth cohort and recommendations for addressing missing data

Doidge, James C., Edwards, Ben, Higgins, Daryl and Segal, Leonie. (2017). Adverse childhood experiences, non-response and loss to follow-up: Findings from a prospective birth cohort and recommendations for addressing missing data. Longitudinal and Life Course Studies. 8(4), pp. 382 - 400. https://doi.org/10.14301/llcs.v8i4.414

Economic predictors of child maltreatment in an Australian population-based birth cohort

Doidge, James C., Higgins, Daryl J., Delfabbro, Paul, Edwards, Ben, Vassallo, Suzanne, Toumbourou, John W. and Segal, Leonie. (2017). Economic predictors of child maltreatment in an Australian population-based birth cohort. Children and Youth Services Review. 72, pp. 14 - 25. https://doi.org/10.1016/j.childyouth.2016.10.012

Risk factors for child maltreatment in an Australian population-based birth cohort

Doidge, James C., Higgins, Daryl J., Delfabbro, Paul and Segal, Leonie. (2017). Risk factors for child maltreatment in an Australian population-based birth cohort. Child Abuse and Neglect. 64, pp. 47 - 60. https://doi.org/10.1016/j.chiabu.2016.12.002

Public health models for preventing child maltreatment: Applications from the field of injury prevention

Scott, Debbie, Lonne, Bob and Higgins, Daryl. (2016). Public health models for preventing child maltreatment: Applications from the field of injury prevention. Trauma, Violence, and Abuse. 17(4), pp. 408 - 419. https://doi.org/10.1177/1524838016658877

How can child welfare and youth-serving organisations keep children safe?

Higgins, Daryl J., Kaufman, Keith and Erooga, Marcus. (2016). How can child welfare and youth-serving organisations keep children safe? Developing Practice.

Conceptualising the prevention of child sexual abuse

Quadara, Antonia, Nagy, Vicky, Higgins, Daryl and Siegel, Natalie. (2015). Conceptualising the prevention of child sexual abuse Australia: Australian Institute of Family Studies, Australian Government.

A public health approach to enhancing safe and supportive family environments for children

Higgins, Daryl J.. (2015). A public health approach to enhancing safe and supportive family environments for children. Family Matters. 96, pp. 39 - 52.

The Stronger Families in Australia (SFIA) study: Phase 2

Edwards, Ben, Mullan, Killian, Katz, Lian and Higgins, Daryl. (2014). The Stronger Families in Australia (SFIA) study: Phase 2 Australia: Australian Institute of Family Studies, Australian Government.

Complex family issues: Collective awareness, common narratives and coordinated approaches to promoting resilience

Hayes, Alan and Higgins, Daryl. (2014). Complex family issues: Collective awareness, common narratives and coordinated approaches to promoting resilience. In In A. Hayes and D. Higgins (Ed.). Families, policy and the law: Selected essays on contemporary issues for Australia pp. 299 - 303 Australian Institute of Family Studies, Australian Government.

Weaving a common narrative: An introduction to essays on families, policy and the law in Australia

Hayes, Alan and Higgins, Daryl. (2014). Weaving a common narrative: An introduction to essays on families, policy and the law in Australia. In Families, policy and the law: Selected essays on contemporary issues for Australia pp. 1 - 4 Australian Institute of Family Studies, Australian Government.

Past adoption practices: Implications for current interventions

Higgins, Daryl. (2014). Past adoption practices: Implications for current interventions. 36(4), pp. 8 - 11.

Contemporary issues in child protection intake, referral and family support

Bromfield, Leah, Arney, Fiona and Higgins, Daryl. (2014). Contemporary issues in child protection intake, referral and family support. In In A. Hayes and D. Higgins (Ed.). Families, policy and the law: Selected essays on contemporary issues for Australia pp. 121 - 129 Australian Institute of Family Studies, Australian Government.

Reform, (r)evolution and lingering Effects: Family policies in Australia

Higgins, Daryl J.. (2014). Reform, (r)evolution and lingering Effects: Family policies in Australia. In In M. Robila (Ed.). Handbook of family policies across the globe pp. 335 - 353 Springer. https://doi.org/10.1007/978-1-4614-6771-7_22

Past adoption practices: Key messages for service delivery responses and current policies

Kenny, Pauline and Higgins, Daryl. (2014). Past adoption practices: Key messages for service delivery responses and current policies. In In A. Hayes and D. Higgins (Ed.). Families, policy and the law: Selected essays on contemporary issues for Australia pp. 29 - 38 Australian Institute of Family Studies, Australian Government.

Multi-type maltreatment and polyvictimisation: A comparison of two research frameworks

Price-Robertson, Rhys, Higgins, Daryl J. and Vassallo, Suzanne. (2013). Multi-type maltreatment and polyvictimisation: A comparison of two research frameworks. Family Matters. 93, pp. 84 - 98.

Past adoption experiences: Impacts, insights and implications for policy and practice

Kenny, Pauline, Higgins, Daryl, Sweid, Reem and Soloff, Carol. (2013). Past adoption experiences: Impacts, insights and implications for policy and practice. Children and Families Australia. 7(1), pp. 35 - 46.

Past adoption experiences: Impacts, insights and implications for policy and practice

Kenny, Pauline, Higgins, Daryl, Sweid, Reem and Soloff, Carol. (2013). Past adoption experiences: Impacts, insights and implications for policy and practice. Communities, Children and Families. 7(1), pp. 35 - 46.

Families make all the difference: Helping kids to grow and learn

Baxter, Jennifer, Higgins, Daryl J. and Hayes, Alan. (2012). Families make all the difference: Helping kids to grow and learn. Family Matters. 90, pp. 98 - 105.

Child abuse and neglect in Australia's Northern Territory: The Northern Territory Emergency Response

Higgins, Daryl and Scott, Debbie. (2012). Child abuse and neglect in Australia's Northern Territory: The Northern Territory Emergency Response. In In H. Dubowitz (Ed.). World perspectives on child abuse pp. 69 - 75 International Society for the Prevention of Child Abuse and Neglect.

Contemporary militant extremism: A linguistic approach to scale development

Stankov, Lazar, Higgins, D., Saucier, Gerard and Knezevic, Goran. (2012). Contemporary militant extremism: A linguistic approach to scale development. In In G. J. Boyle, Donald H. Saklofske and G. Matthews (Ed.). Psychological Assessment pp. 41 - 67 SAGE Publications Inc..

Child maltreatment and health service use : Findings of the Australian Child Maltreatment Study

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