COVID-19 Pandemic Linked to Initial Decline, Later Increase in Severity of Child Maltreatment Cases

Initial public health measures and restricted healthcare access during the early stages of the COVID-19 pandemic were associated with a decrease in hospital admissions for child maltreatment in Canada. However, this decline was followed by an increase in the severity of cases requiring intensive care unit (ICU) admission, according to a recent population-based study.

Study Findings

Researchers analyzed health administrative data from all Canadian provinces and territories, spanning from April 3, 2016, to March 25, 2023. The study, published in the Canadian Medical Association Journal, focused on children under two years of age. A total of 1,518 hospital admissions for maltreatment were identified during the study period.

• Initial Decline: A 31% reduction in hospital admissions for maltreatment was observed during the first 16 weeks of the pandemic (March 1, 2020, to June 20, 2020). (https://www.cmaj.ca/content/195/8/E251317)
• ICU Admission Reduction: A significant 56% reduction in ICU admissions for maltreatment was also noted during the same initial 16-week period. (https://www.cmaj.ca/content/195/8/E251317)
• Post-Restriction Increase in Severity: Following the period of restricted healthcare access, the rate of ICU admissions for child maltreatment increased by 80%. (https://www.cmaj.ca/content/195/8/E251317)

Factors Contributing to the Trends

The study suggests that the initial decline in hospital admissions may be attributed to reduced access to healthcare services and fewer interactions between children and professionals who typically identify and report maltreatment, such as teachers and healthcare providers. Canada implemented some of the most stringent public health measures during the pandemic, including school and childcare closures. (https://www.cmaj.ca/content/195/8/E251317)

The subsequent increase in ICU admissions could indicate that cases of maltreatment were not detected early on, leading to more severe injuries requiring intensive care. Increased household stress and social isolation during the pandemic may have also contributed to the severity of abuse cases. (https://www.cmaj.ca/content/195/8/E251317)

Data Sources and Methodology

The research team utilized data from the Canadian Institute for Health Information (CIHI) Discharge Abstract Database (DAD) and the Institut national d’excellence en santé et en services sociaux (INESSS) in Quebec. An interrupted time-series analysis was conducted to assess changes in hospital admission rates before and during the pandemic. (https://www.cmaj.ca/content/195/8/E251317)

Implications for Future Pandemic Preparedness

The findings highlight the importance of maintaining child safety during public health emergencies. Future pandemic preparedness plans should prioritize strategies to ensure continued identification and treatment of child maltreatment cases, even during periods of restricted healthcare access. (https://www.cmaj.ca/content/195/8/E251317)

The Canadian Institute for Health Information (CIHI) continues to collect and analyze data related to the impact of COVID-19 on Canada’s healthcare systems. More information can be found on the CIHI website.