|
Abstract
|
Violence, including homicide, child abuse and neglect, and assault by peers and others, causes over 2000 deaths a year to US children aged 0 to 19 years. Homicide is a leading cause of death for US children and adolescents, and so a major cause of years of potential life lost. Infantile and adolescent patterns of homicide are recognized: child abuse by parents characterizes the former; gunshots and other assaults by peers characterize the latter. Nonfatal violent injury is far more prevalent than the fatalities. Reliable estimates indicate that each year close to 1 million female adolescents are sexually assaulted, and more than 1.5 million children and adolescents are abused by the adults responsible for them. Adolescents experience violent crimes at extremely high rates. Risk factors for violent injury are recognized. The most consistent include male sex (except for sexual abuse) and urban residence. Despite the toll of violence, surprisingly little is known about its origins and means to prevent it. The only prevention approach that has been both well evaluated and of apparent benefit is the home health visitor for prevention of child abuse in infants of young, impoverished, unmarried primiparous women. Many other approaches are plausible, promising, and/or being implemented, and these require thorough trial and evaluation. Research on numerous aspects of the precursors and correlates of violence against children is also needed.
VioLit summary:
OBJECTIVE:
The aim of this study by Christoffel was to explore the phenomenon of violent death and injury in children and adolescents in the United States today.
METHODOLOGY:
The author conducted a cross-sectional secondary analysis of data from the 1985 National Center for Health Statistics, obtained from death certificates, and of data from the Federal Bureau of Investigation, compiled from police records. For assaults that did not result in death, 1985 National Crime Survey data were used. Consumer Product Safety Commission data from 1980 were used to determine emergency department utilization, data from the second National Incidence Survey were employed in the search for child abuse information, and 1985 United States Census Bureau statistics were included to calculate population rates. The paper addressed the issue of violence for children aged 0 to 19 years, and presented data for 1985. Violent injuries explored in the study included child abuse and neglect (maltreatment by responsible adults), assault (by strangers, peers or others not responsible for the victim), and homicide (death due to child abuse and neglect, or assault). Analyses involved examination of frequencies and rates of violence.
FINDINGS/DISCUSSION:
The author began with an examination of some recent statistics concerning violent death and injury in children and adolescents. Children in the United States have an atypically high rate of homicide compared with those in other developed countries, and years of potential life lost have increased by 44% from 1968 to 1985. Firearms have been the leading means of homicide for victims aged 12 years and over, and handgun homicide rates have increased fivefold since the 1960s. Nonfatal assaults by people not responsible for their victims have been estimated to be 100 times more frequent than homicides. Studies have found that 5% to 7% of female adolescents report experiencing at least one sexual assault annually, and fewer than 20% of offenders were unknown to their victims. Child abuse has been found to be the leading cause of homicide in the first few years of death, with 1,000 deaths a year. Turning to a secondary analysis of data from 1985, FBI information showed that 2,227 children and adolescents aged 0 to 19 years were victims of homicide in that one year. This figure represented 12.7% of all murder victims in the United States in 1985. 60% of the child and adolescent victims were aged 15 to 19 years; 23% were under the age of 5. National Center for Health Statistics data showed that, whilst total homicide rates for white males aged 15 to 19 were 7.3 per 100,000, rates for black males of the same age were more than six times greater, at 46.4 per 100,000 population. Black female homicide rates were two to four times higher than those of white females. Years of potential life lost in the 15 to 19 age group were over 27,000 for white males, and almost 31,000 for black males. Years lost for white females were actually higher than those for black females in all age groups, with 15 to 19 year olds having almost 10,000 years of potential life lost for white females, and almost 7,000 years lost for black females. Looking at National Crime Survey data, for most categories of violent crime, the highest incidence rates were found in the 16 to 19 year old age group, whilst crime victimization rates of males were twice those of females. Whilst costs of violent injury cannot be definitively estimated, costs of nonfatal injuries include medical care, legal and social investigations, and interventions such as rehabilitation or placement, and costs of fatal injuries include forensic investigations and years of potential life lost. Prevention efforts for violence have not been clearly proven to be effective, but, according to the author, they are promising. Primary interventions are those which can reduce incidence rates and which are directed toward whole populations and the prevention of fatal injuries, whilst secondary interventions are those which can ameliorate the effects of injury, or reduce recurrence of injury, after it has occurred.
AUTHOR'S RECOMMENDATIONS:
Primary prevention of homicide and assault could begin with training in self-protection techniques, to teach adolescents to handle themselves in situations in which they would otherwise be ill prepared to escape. Gun control must be addressed in homicide prevention, as current regulations do not suffice. Regulations could include harsher penalties for firearm violence, prohibition of high-risk groups (such as the very young, alcoholics, and mental patients) from owning guns, licensing, registration and bans. Design safety features, background checks and reductions in the availability of realistic toy guns have also been thought to be potentially effective interventions. Educational guidance and modifying media portrayal of violence could be useful, as could peer-oriented approaches during adolescence. Secondary prevention to combat homicide could include referral at the time of injury to appropriate support services, and school-based programs directed at high-risk youth. Primary intervention of child abuse should include home health visitors to provide support and education to parents to reduce the incidence of child abuse and neglect. By employing an ecological view of child abuse, accepting that child abuse is the outcome of many interrelated factors, parental knowledge and skills could be directed toward handling difficult childhood behaviors and life situations. Today's children could be taught the essentials of child development and care, and more effective child-rearing practices. Programs aimed at sexual abuse center upon training in self-protection knowledge and skills, to teach the idea that familiar people can be abusers. Secondary prevention of child abuse has included removal from abusive homes and placements in foster homes, although the efficacy of such intervention has been unclear. Research needs are vast in the area of violence prevention. Studies of primary prevention should be given first priority, as well as evaluation studies of preventive intervention. Coordination of research and development of research is critical, as is integration of related research areas. A common terminology for violence research should be developed, and multiple factors should be included in analyses. Priority should also be given to high-risk sub-populations such as black children and adolescents, and the role of family disruption in the development of violence should be thoroughly considered. Assessment of sexual abuse programs and interventions is also essential, and methodologies and designs should be carefully implemented and more detailed. For such accurate evaluation and research, adequate funding is a necessary prerequisite. The author concluded that the end of childhood violence will come when the control of violence becomes a national priority.
EVALUATION:
The author presents an interesting discussion of the issue of violent death and injury in children and adolescents in the United States. The background review provides a good discussion of recent research findings, although this section could have been somewhat more detailed and specific. The examination of 1985 data provides a clear picture of recent trends, and acts as a step from which to turn to the issue of prevention. The discussion of prevention and intervention options is the primary accomplishment of this paper, and should act as a direction for both researchers and prevention planners alike.
(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - Early Childhood
KW - Middle Childhood
KW - Late Childhood
KW - Late Adolescence
KW - Early Adolescence
KW - Infant Victim
KW - Child Victim
KW - Juvenile Victim
KW - 1980s
KW - Homicide Rates
KW - Homicide Victim
KW - Homicide Incidence and Prevalence
KW - Victimization Rates
KW - Victimization Incidence and Prevalence
KW - Injury Incidence and Prevalence
KW - Injury Rates
KW - Child Injury
KW - Juvenile Injury
KW - Physical Assault Effects
KW - Physical Assault Incidence and Prevalence
KW - Physical Assault Injury
KW - Physical Assault Victim
KW - Child Abuse Fatality
KW - Child Abuse Homicide
KW - Child Abuse Incidence and Prevalence
KW - Child Abuse Rates
KW - Child Abuse Victim
KW - Child Physical Abuse Incidence and Prevalence
KW - Child Physical Abuse Victim
KW - Child Neglect Incidence and Prevalence
KW - Child Physical Abuse Rates
KW - Child Neglect Rates
KW - Child Neglect Victim
KW - Domestic Homicide
KW - Domestic Violence Victim
KW - Domestic Violence Incidence and Prevalence
KW - Domestic Violence Rates
KW - Age Factors
KW - Death Rates
Language: en |