Inflicted violence-related injuries among children and youth in Ontario during the COVID-19 pandemic

Alexia Medeiros; Lennon Li; Brendan T. Smith; Sarah Carsley; Alex Zheng; Ian Pike; Alison K. Macpherson; Justin Thielman; Ashini Weerasinghe; Shazya Karmali; Natasha Saunders; Sarah A. Richmond

Child Protection and Practice (Aug 2024)

Inflicted violence-related injuries among children and youth in Ontario during the COVID-19 pandemic

Alexia Medeiros,
Lennon Li,
Brendan T. Smith,
Sarah Carsley,
Alex Zheng,
Ian Pike,
Alison K. Macpherson,
Justin Thielman,
Ashini Weerasinghe,
Shazya Karmali,
Natasha Saunders,
Sarah A. Richmond

Affiliations

Alexia Medeiros: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada; School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
Lennon Li: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada
Brendan T. Smith: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street #500, Toronto, ON, M5T 3M7, Canada
Sarah Carsley: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street #500, Toronto, ON, M5T 3M7, Canada
Alex Zheng: BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, F508 – 4480 Oak St., Vancouver, BC, V6H 3V4, Canada
Ian Pike: BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, F508 – 4480 Oak St., Vancouver, BC, V6H 3V4, Canada
Alison K. Macpherson: School of Kinesiology and Health Science, Faculty of Health, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada; ICES, 2075 Bayview Ave V Wing, M4N 3M5, Toronto, ON, Canada
Justin Thielman: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada
Ashini Weerasinghe: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada
Shazya Karmali: BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, F508 – 4480 Oak St., Vancouver, BC, V6H 3V4, Canada
Natasha Saunders: ICES, 2075 Bayview Ave V Wing, M4N 3M5, Toronto, ON, Canada; The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada; Department of Pediatrics, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada; Child Health Evaluative Sciences, SickKids Research Institute, 555 University Avenue, Toronto, ON, M5G 1X8, Canada; Institute of Health Policy, Management and Evaluation, The University of Toronto, 155 College Street #500, Toronto, ON M5T 3M7, Canada; Temerty School of Medicine, The University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada; Edwin S.H. Leong Centre for Healthy Children, Peter Gilgan Centre for Research & Learning the Hospital for Sick Children, 686 Bay Street, 11th Floor, Toronto, ON, M5G 0A4, Canada
Sarah A. Richmond: Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street #500, Toronto, ON, M5T 3M7, Canada; Corresponding author. Public Health Ontario, 480 University Avenue #300, Toronto, ON, M5G 1V26, Canada.

Journal volume & issue: Vol. 2
p. 100020

Abstract

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Background: During the COVID-19 pandemic, it was hypothesized that stay-at-home policies would impact cases of violence, abuse, and neglect among children and youth due to increased familial stressors. Objective: We examined the effect of the implementation of pandemic policies on violence-related emergency department (ED) visits and hospitalizations among youth. Participants: Violence-related ED visits and hospitalizations among children and youth ages 0–19 in Ontario, Canada were obtained from April 2015 until the most recent available date, March 31, 2022. Methods: We used an interrupted time series design to model the change in monthly violence-related ED visits and hospitalizations before and during the pandemic. We used negative binomial models to estimate the immediate effect of the policy and the change in the number of injuries during the pandemic. Results: After adjusting for seasonality and population changes over our study period, we observed a 56% decrease in violence-related ED visits (RR: 0.44, 95%CI: 0.38, 0.50) and a 35% decrease in hospitalizations (RR: 0.65, 95%CI: 0.52, 0.82) immediately after the implementation of the pandemic policy, followed by moderate increasing trends. We observed no difference in the effect of the pandemic policies on the rate of violence-related ED visits and hospitalizations by sex, age or material deprivation; however, males aged 10–19 years and those in higher quintiles of material deprivation had higher average rates of injuries compared to females, those in younger age groups and lower quintiles of deprivation over the study period. Conclusions: We observed an abrupt decrease in the rate of violence-related ED visits and hospitalizations immediately after the onset of pandemic policies in Ontario. Following this, violence-related injuries increased, approaching pre-pandemic levels.

Published in Child Protection and Practice

ISSN: 2950-1938 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Social Sciences: Social sciences (General)
Website: https://www.sciencedirect.com/journal/child-protection-and-practice

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