Each year, more than a billion children ages 2-17 experience violence globally in physical, sexual and emotional forms, according to a new study. That’s more than 110,000 children per hour.
The study, “Global Prevalence of Past-Year Violence against Children: A Systematic Review and Minimum Estimates” (Pediatrics. Jan. 25, 2016, http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2015-4079), is the first peer-reviewed research to estimate the prevalence of past-year violence against children under 18 at a global level.
“We’re beginning to see violence at a global public health level with importance every bit as strong as tobacco exposure, alcohol exposure and lack of access to clean water. Anyone would agree these numbers are highly disturbing,” said lead author Susan Hillis, Ph.D., M.S.N., senior adviser for global health at the Centers for Disease Control and Prevention’s (CDC’s) National Center for Injury Prevention and Control and captain, active duty, in the U.S. Public Health Service.
The study looked at 38 reports encompassing 96 countries on past-year prevalence of violence against children. The data included age groups affected and type of violence (physical, sexual and emotional or multiple types). Investigators used a triangulation approach that synthesized data to general minimum regional prevalence derived from population-weighted averages of the country-specific prevalence.
Asia, Africa and North America experienced the most past-year violence, affecting about 50%-60% of the children.
The study’s investigators are calling for more population-based surveillance of violence against children to target prevention.
“We know the long-term exposures to severe forms of stress can damage the connections forming inside of the child’s brain, both the architecture, structure and function, causing the child to be sick more often and also increasing damage to many body systems — the nervous, the endocrine, the immunologic and inflammatory systems,” Dr. Hillis said.
Exposure to violence also has epigenetic effects. “We know that they lead to increases in all major causes of death in adulthood at a global level,” she said, including infectious diseases, cancer, heart disease, stroke, diabetes, injury, mental health and reproductive health problems.
On Jan. 1, the United Nations’ new global commitment to end all violence against children was enacted as part of the 2030 Sustainable Development Agenda. The goal is for every country to “end abuse, exploitation, trafficking, and all forms of violence against children” and to “eliminate all forms of violence against women and girls.”
Pediatricians can support violence prevention through anticipatory guidance and linking patients to screening services and interventions. The CDC developed a THRIVES package that is being adapted to the global framework. THRIVES includes information on Training in parenting; Household economic strengthening; Reduced violence through legal protection; Improved services; Values and norms that protect children; Education and life skills; and Surveillance and evaluation. Tools for pediatricians also can be found on the AAP Resilience Project Web page (see resources).
“We know violence can be prevented,” Dr. Hillis said. “We know if we don’t prevent it, it can damage a billion brains and bodies, a billion lives and livelihoods.”