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Childhood maltreatment could lead to early death in adulthood


Maltreatment in childhood has negative consequences for a child’s health, but an investigation looks into whether it can increase the risk of early mortality.

No child should be subjected to maltreatment, but it unfortunately remains a global public health issue. The harm in childhood caused by maltreatment has been understood, but the long-term impact of abuse on mortality later in life has been little studied. An investigation in Pediatrics offers some insight into how being mistreated in childhood can impact mortality on early adulthood.1

Researchers ran a retrospective cohort study of every person who was born in South Australia between 1986 and 2003 and used linked administrative data. Exposure to child maltreatment was tied to contact with child protection service. A person was considered unexposed to maltreatment if there was no contact with child protection service before age 16 years. Deaths were tracked until May 31, 2019 and plotted from 16 years of age.

A total of 331,254 people were included in the cohort and 20% had contact with child protection services. The researchers found that people who had a child protection matter notification as well as either a nonsubstantiated or a substantiated investigation had a death rate that was more than twice the rate found with people who had no child protection service contact adjusted hazard ratio (aHR) = 2.09 (95% CI = 1.62–2.70) to aHR = 2.61 (95% CI = 1.99–3.43). When compared to no contact with child protective services, people who had ever been placed in out-of-home care were found to have the highest mortality if they had been first placed in care aged ≥ 3 years (aHR = 4.67 [95% CI = 3.52–6.20]). Researchers found the largest differential cause-specific mortality, any contact versus no child protection services, was death from suicide (incident rate ratios [IRR] = 2.82 [95% CI = 2.15–3.68]) as well as poisonings, alcohol, and/or other substances (IRR = 4.82 [95% CI = 3.31–7.01])

Researchers concluded that child maltreatment is an important underlying cause of deaths that are potentially avoidable in the early part of adulthood. They urge making clinical and family-based support for families affected by child maltreatment to protect the child from both the imminent risk of harm as well as early death in adulthood as a result.


1. Segal L, Armfield J, Gnanamanickam E, et al. Child maltreatment and mortality in young adults. Pediatrics. December 14, 2020. Epub ahead of print. doi:10.1542/peds.2020-023416

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