Abusive Head Trauma Injuries Linked to Socioeconomic Status, Age and Gender

November 4, 2013

A new study estimates that more than seven children under the age of five with abusive head trauma were treated each day in U.S. emergency departments between 2006 and 2009. Abusive head trauma is a serious injury resulting from an assault on a young child leading to injuries on the brain, and is the leading cause of death in child abuse cases in the U.S.

The study, led by researchers in the Center for Injury Research and Policy of The Research Institute at Nationwide Children’s Hospital, found that children under the age of one from families with low socioeconomic status are at highest risk from abusive head injury. According to the study published in Brain Injury in October, households with a lower median income in their zip code had a higher frequency of abusive head trauma. Abusive head trauma patients were also more likely to be enrolled in Medicaid.

The study’s authors hypothesize that households with lower incomes are under more stress than households with higher incomes and this stress increases the risk of physically aggressive responses to child behaviors. It could also reflect a bias in the diagnosis and reporting of abuse by medical professionals.

“The data suggests the need for prevention efforts focusing on educating child caregivers about the serious consequence of abusive head trauma and proper practice in caring for infants, including to never shake a baby,” said Krista Wheeler, a senior research associate with the Center for Injury Research and Policy at Nationwide Children’s and an author of the study. “Study findings indicate the need to increase strategies to prevent head trauma among children, including parent education in the newborn nursery regarding how to appropriately handle infant crying, formal home visiting programs and parent support groups.”

Comparing abusive head trauma injuries to head injuries not caused by abuse, patients with abusive head trauma were significantly younger. Abusive head trauma patients have a significantly higher mortality rate and worse outcomes than children with other head traumas that are not linked to abuse. Previous studies have shown that 85 to 90 percent of patients with abusive head trauma had impairment or disability as a result of their injury.

In 2008, The Centers for Disease Control and Prevention (CDC) standardized the way that abusive head trauma was defined to allow for better public health surveillance and understanding of abusive head trauma patterns, and this is the first study to apply this definition to nationally representative emergency department data.

The Center for Injury Research and Policy (CIRP) of The Research Institute at Nationwide
Children’s Hospital works globally to reduce injury-related pediatric death and disabilities. With innovative research as its core, CIRP works to continually improve the scientific understanding of the epidemiology, biomechanics, prevention, acute treatment and rehabilitation of injuries. CIRP serves as a pioneer by translating cutting edge injury research into education, policy and advances in clinical care. For related injury prevention materials or to learn more about CIRP visit http://www.injurycenter.org.

About Nationwide Children's Hospital

Named to the Top 10 Honor Roll on U.S. News & World Report ‘s 2018-19 list of “Best Children’s Hospitals,” Nationwide Children’s Hospital is one of America’s largest not-for-profit freestanding pediatric health care systems providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children and adolescents, as well as adult patients with congenital disease. Nationwide Children’s has a staff of more than 13,000 providing state-of-the-art pediatric care during more than 1.4 million patient visits annually. As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. More information is available at NationwideChildrens.org.