Long-term trends in child maltreatment in England and Wales, 1858-2016: an observational, time-series analysis
Long-term trends in child maltreatment in England and Wales, 1858-2016: an observational, time-series analysis
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DOI：
10.1016/s2468-2667(19)30002-7
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发表时间：
2019-03-01
影响因子：
50
通讯作者：
Bowes, Lucy
中科院分区：
文献类型：
--
作者：
Degli Esposti, Michelle;Humphreys, David K.;Bowes, Lucy
背景目前尚不清楚虐待儿童在英格兰和威尔士是在增加还是在减少。需要更多的证据，从多个来源和更长的时间段来探索虐待儿童的趋势。我们使用官方记录数据和时间序列方法调查了儿童虐待的年度发病率是否随着时间的推移而变化。方法在这个观察性的时间序列分析中，我们使用了六个数据来源(政府的儿童死亡率记录、警方记录的儿童杀人案、针对儿童的犯罪记录、儿童保护和托管所儿童；以及NSPCC数据)来估计英格兰和威尔士儿童虐待的发生率并检查长期趋势。我们纳入了具有全国代表性的数据，这些数据可以估计超过25年的虐待儿童的发生率。我们的主要结果是包括或不包括威尔士在内的英格兰每12个月虐待儿童的受害者(16岁)的数量。我们拟合泊松回归模型，以年为暴露时间，以虐待儿童受害者或施暴者的数量为结果(根据人口、年龄结构和规模进行调整)。当线性趋势不合适时，我们用惩罚样条法对广义加法模型进行拟合，以可视化趋势。我们发现，1858年至2016年间，儿童因凶杀或袭击而死亡的发生率下降了90%(每10万名儿童中有2.7人)，而虐待或忽视儿童的发生率在1893年至2016年间下降了83%(每10万名成年人中有6.7人)，而儿童保护登记在1988年至2016年间增加了182%(每10万名儿童中有328.7人)。2000至2016年间，针对儿童和进入托儿所的儿童的犯罪有所增加。2016年，40名儿童死于他杀，青少年(15-19岁)死亡人数是婴儿(年龄)死亡人数的两倍
Background It is unclear whether child maltreatment is increasing or decreasing in England and Wales. More evidence is needed, from multiple sources and over longer periods of time, to explore trends in child maltreatment. We investigated whether the annual incidence of child maltreatment has changed over time, using official record data and time-series methods to establish long-term trends.Methods In this observational time-series analysis, we used six data sources (Government records for child mortality, police-recorded child homicides, crimes against children, child protection, and children in care; and NSPCC data) to estimate the incidence of child maltreatment in England and Wales and examine long-term trends. We included nationally representative data that could estimate the incidence of child maltreatment for more than 25 years. Our primary outcomes were the number of victims (age 16 years) of child maltreatment per 12-month period in England, including or excluding Wales. We fitted Poisson regression models with year as the exposure and the number of victims or perpetrators of child maltreatment as the outcome (adjusted for population age-structure and size). When a linear trend was not appropriate, we fitted generalised additive models with penalised splines to visualise trends.Findings The incidence of child mortality by homicide or assault decreased by 90% (2.7 per 100 000 children) between 1858 and 2016 and the incidence of people guilty of child cruelty or neglect decreased by 83% (6.7 per 100 000 adults) between 1893 and 2016, whereas child protection registrations increased by 182% (328.7 per 100 000 children) between 1988 and 2016. Crimes against children and children entering care increased between 2000 and 2016. In 2016, 40 children died by homicide, with twice as many adolescent (15-19 years) deaths than infant (age