Family violence

Objectives To investigate maternal child protection histories, and offspring child protection contacts and developmental outcomes, for children at age 5 years.Study DesignObservational cohort study using linked South Australian administrative birth, perinatal, child protection and child development data.Participants, SettingChildren with a South Australian birth registration and a record in the 2009, 2012, 2015 or 2018 Australian Early Development Census (AEDC).Main Outcome MeasuresHighest level of child protection system contact for children before starting school, and developmental vulnerability on one or more AEDC domains.ResultsOf 69,332 children, 7522 (10.8%) had a mother with a history of any child protection contact, and 1019 (1.5%) had a mother with at least one out-of-home care placement. Maternal child protection history was associated with increasing levels of socio-economic and health disadvantage around the time of birth. For example, overall there were 8245/69,332 (11.9%) children born into a home where the parent(s) were unemployed, compared with 549/1019 (53.9%) with a maternal out-of-home care history. For children whose mothers had child protection contact, 3793/7522 (50.4%) had their own child protection contact by age 5 years, compared with 7033/61,810 (11.4%) for children whose mothers had no contact. Of 6771 children whose mothers had child protection contact, 2724 (40.2% [95% confidence interval], 39.1%–41.4%) were developmentally vulnerable on one or more AEDC domains when they started school, compared with 12,002/58,165 (20.6% [95% confidence interval], 20.3%–21.0%) children with no maternal child protection history.ConclusionChild protection contact is common in both mothers and children, and maternal child protection history carries an increased burden of poor development outcomes at school entry. The scale and intersection of child protection system contact, early life disadvantage and poor development outcomes have implications for appropriately resourcing health-led supportive responses as early as possible during the perinatal and early childhood periods.

Meredith Forsyth, Alicia Montgomerie, Kathleen Falster, Deepa Jeyaseelan, Paul Hotton, John Lynch, Rhiannon M. Pilkington

Elder abuse can lead to serious physical injuries and long-term psychological consequences, but its recognition and documentation in healthcare settings remain limited. This study used linked data from four Australian states to examine elder abuse coded during emergency department presentations and hospitalisations among 965,986 older people assessed for aged care services between 2010 and 2019. Only 580 people (0.06%) had elder abuse coded during an emergency department presentation or hospitalisation, highlighting substantial under-recognition and under-reporting in hospital settings.

Stephanie L. Harrison, Sahar Barmomanesh, Bryan Morden, Maria C. Inacio, Gillian E. Caughey, on behalf of the ROSA Consumer and Community Advisory Committee