My Turn: Child abuse prevention and the pandemic

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Published: 4/20/2022 5:17:59 PM
Modified: 4/20/2022 5:16:42 PM

April is Child Abuse Prevention Month. It may also be the month we transition from pandemic to endemic with COVID-19. 

For the past two years, as a pediatric expert in child abuse, the most common question I have been asked is, “What has COVID-19 done to child abuse rates?” The answer ends up being complicated, but I think it also carries lessons for the future.

In the first six months of the 2020 response to the pandemic, I noted a decrease in the worst forms of abuse, abuse that requires hospitalization. This phenomenon was also experienced by many of my colleagues here at home and around the world. I had to ask myself, “Why would that be?”  I believe there are two answers.

Abuse usually happens when one overwhelmed caretaker snaps and strikes out at a child. It is much less likely to happen when other adults are present. The pandemic kept many people home. Children were less likely to be left alone with one adult. There were more hands to help, and more eyes to see how children were treated. This was protective.

Financial supports to families was a very vigorous and very important part of the early response to the pandemic. Many financially stressed people benefitted substantially from COVID-19 relief measures. Past research has shown that economic aid to families, such as the refundable earned income tax credit, housing assistance, the Affordable Care Act, and other economic assistance programs, reduces rates of child abuse and foster care placement. Financial assistance during the pandemic did what it was intended to do, protect fragile families and their children.

It would be nice if this story ended here. However, early in 2021 I saw a significant increase in child abuse hospitalizations, even above pre-pandemic case rates. Again, I had to ask myself why, and once more I think there are two answers.

By 2021 we were all growing very weary of pandemic measures, many of us were affected by the loss of health, friends and family, and the stress built to a breaking point. It is tempting to see people who abuse children as monsters, different from the rest of us and easily recognizable. The truth is that, while some personality characteristics may make people more prone to violence, most child abusers usually act and look like you or me much of the time. It could be anyone — someone you work with or know or a family member or friend. Abusers hurt children in the worst moment of their life, in response to overwhelming stress. And, let’s be honest, the pandemic has been stressful on everyone. Stressed out caretakers attending to stressed out kids was a powder keg just waiting to blow.

A factor well known to prevent child abuse is social connectedness. Adult time with friends, family gatherings, and social events were a casualty of the pandemic. We had to wear masks and social distance from others. Even the smallest of gatherings were considered unsafe, and major events like concerts and sports games were canceled or played without a live audience. You couldn’t visit grandma for fear of exposing her, and you couldn’t visit her in the hospital or attend her funeral if she became ill or died. This both contributed to stress and prevented our most human method of coping with stress, connecting to each other. Being stressed, isolated, and uncertain when COVID would even end was incredibly hard on people, and children bore the cost of that pain.

We are all hopeful that the pandemic is finally coming to an end. Time will tell, but already masks are coming off, people are going to restaurants and the movies, and families are gathering together. In this moment, I am asking whether we will forget the things that we learned during the pandemic. Will every child of a working parent have access to a multi-caretaker day care center or preschool?  Will working a full-time job be enough for a parent to keep their children out of poverty?  Will families and communities cherish each other and cherish their children enough to shoulder their burdens together so that stresses are bearable by all?  This April I ask us all to answer each of these questions, “Yes.” I know this is an audacious aspiration. However, there was already research data to indicate that each of these things benefits the children who are our future. My pandemic experience, both good and bad, has served to reinforce these lessons.

So what can we all do to make a difference?  

Some solutions involve political advocacy, reaching out to legislators who support children and advocate for living wage legislation and affordable, quality, multi-provider daycare for every citizen. Some solutions are more personal. If you know a family who could use some help, a mother struggling with depression, or a child who needs an open ear, you can lend a hand to each of those. Genuine social connections have been a casualty of our electronically connected age and our pandemic response. We can change that.  

If you have reasonable cause to believe a child may be harmed by abuse or neglect, you can report it to DCF at (800) 792-5200. DCF determines that abuse has genuinely occurred less than half of the time, and only one in three to one in four of those children are ever removed from their families. DCF is required by law to try to keep or put families back together and to provide families assistance to resolve the problems harming their child.  

Finally, there is a dire shortage of quality foster homes in our area. If you can find it in your heart to open your home to a child who does not have a safe home of their own, your altruistic desire to help them will be rewarding for you by helping a child in their greatest  time of need.

Stephen C. Boos, MD, FAAP, is co-medical director of the Baystate Family Advocacy Center at Baystate Children's Hospital in Springfield and Professor of Pediatrics at UMass Chan Medical School-Baystate. 


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