Background

COVID-19 has had a major impact on child abuse and neglect (CAN) in the U.S. leading to a change in the number of reported screened-in CAN investigations, missed prevention cases, and missed CAN cases.

Objectives

To estimate the deficit number of CAN investigations and resultant estimated number of missed prevention and CAN cases due to the COVID-19 pandemic in the U.S. from March 2020 to December 2020.

Methods

Secondary data analyses of administrative child welfare data from January 2013 to December 2020 from New York City, Florida, New Jersey and Wisconsin were conducted. Spline regression modeling controlling for autocorrelation was utilized to explore any significant changes once the pandemic began in March 2020 in the number of screened-in CAN investigations. The seven-year monthly average of screen-in CAN investigations for March through December from 2013 to 2019 was calculated and compared to the numbers of CAN investigations for March 2020 to December 2020. The resultant number of missed prevention cases and CAN cases was estimated for the four jurisdictions and used to approximate the number of missed prevention cases and CAN cases in the U.S., as well as the projected estimation of national lifetime economic costs.

Results

Prior to the pandemic, there were insignificant monthly increases of 0.7 CAN investigations in NYC and 6.2 CAN investigations in Florida, a significant monthly increase 4.2 CAN investigations in New Jersey and an insignificant monthly decrease in 0.6 CAN investigations in Wisconsin. Once the pandemic began, there were significant monthly decreases (p < .001) in each of the four jurisdictions, including 1425.6 fewer CAN investigations in NYC, 3548.0 fewer CAN investigations in Florida, 963.0 fewer CAN investigations in New Jersey and 529.1 fewer CAN investigations in Wisconsin. There were an estimated 60,791 fewer CAN investigations in these four jurisdictions from March 2020 to December 2020 of which there were approximately 18,540 missed prevention and CAN cases suggesting up to $4.2 billion in lifetime economic costs. It was estimated that were 623,137 children not investigated for CAN in the U.S. during the same 10-month period. This suggests that there were an estimated 85,993 children were missed for prevention services and about 104,040 children were missed for CAN with a potential lifetime economic impact of up to $48.1 billion in the U.S.

Conclusions

The COVID-19 pandemic has led to a precipitous drop in CAN investigations where almost 200,000 children are estimated to have been missed for prevention services and CAN in a 10-month period. There are opportunities for the child welfare jurisdictions to work with partner education, public health, social service and other providers to strategically approach this very grave issue in order to mitigate its impact on this very vulnerable population.

中文翻译：

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计算 COVID-19 大流行对美国虐待和忽视儿童的影响

背景

COVID-19 对美国的儿童虐待和忽视 (CAN) 产生了重大影响，导致报告的 CAN 筛查调查、漏诊病例和 CAN 漏诊病例数量发生变化。

目标

估计 2020 年 3 月至 2020 年 12 月期间美国因 COVID-19 大流行而导致的 CAN 调查的赤字数量以及由此产生的错过预防和 CAN 病例的估计数量。

方法

对纽约市、佛罗里达州、新泽西州和威斯康星州 2013 年 1 月至 2020 年 12 月的行政儿童福利数据进行了二次数据分析。一旦大流行于 2020 年 3 月开始，控制自相关的样条回归模型被用于探索筛选的 CAN 调查数量的任何重大变化。计算了 2013 年至 2019 年 3 月至 12 月 CAN 筛查调查的七年月平均值，并将其与 2020 年 3 月至 2020 年 12 月的 CAN 调查数量进行了比较。由此产生的漏防病例数和 CAN 病例数估计为四个司法管辖区，用于估算美国错过的预防案例和 CAN 案例的数量，以及国家生命周期经济成本的预计估计。

结果

在大流行之前，纽约市的 CAN 调查每月增加 0.7 次，佛罗里达州的 CAN 调查每月增加 6.2 次，新泽西州的 CAN 调查每月增加 4.2 次，威斯康星州的 CAN 调查每月减少 0.6 次。大流行开始后，四个辖区中的每一个都出现了显着的月度下降 (p < .001)，其中纽约市的 CAN 调查减少了 1425.6 次，佛罗里达州的 CAN 调查减少了 3548.0 次，新泽西州的 CAN 调查减少了 963.0 次，CAN 调查减少了 529.1 次在威斯康星州。从 2020 年 3 月到 2020 年 12 月，这四个司法管辖区的 CAN 调查估计减少了 60,791 起，其中约有 18,540 起漏防，CAN 案件表明终生经济成本高达 42 亿美元。据估计，在同一 10 个月期间，美国有 623,137 名儿童未接受 CAN 调查。这表明，估计有 85,993 名儿童因预防服务而被遗漏，约有 104,040 名儿童因 CAN 而被遗漏，在美国可能造成的终生经济影响高达 481 亿美元

结论

COVID-19 大流行导致 CAN 调查急剧下降，据估计，在 10 个月的时间里，将近 200,000 名儿童因预防服务和 CAN 而被遗漏。儿童福利辖区有机会与伙伴教育、公共卫生、社会服务和其他提供者合作，从战略上解决这个非常严重的问题，以减轻其对这一非常脆弱人群的影响。