Spotlight on child abuse and neglect response in the time of COVID-19
Authors: Elizabeth York Thomas, Ashri Anurudran, Kathryn Robb, Thomas F Burke
Journal: The Lancet Public Health (2020)

The call from Joht Chandan and colleagues to adopt a public health approach toward pandemic-related increases in domestic violence ought to be heeded.1Chandan JS Taylor J Bradbury-Jones C Nirantharakumar K Kane E Bandyopadhyay S COVID-19: a public health approach to manage domestic violence is needed.Lancet Public Health. 2020; 5: e309Summary Full Text Full Text PDF PubMed Scopus (143) Google Scholar Adoption of their framework for evaluating and addressing domestic violence and child abuse and neglect can create public health benefits that far outlast the current crisis. School systems and youth-serving organisations can and should play a vital role in addressing the increased abuse and neglect of children during the COVID-19 pandemic. In the USA, 20% of reports of abuse and neglect to child protective services are made by educational personnel, making educators the country's primary reporters.2Children's BureauChild maltreatment 2018. US Department of Health and Human Services, Washington, DC2018Google Scholar Despite evidence that the incidence of child abuse and neglect has substantially increased during the COVID-19 pandemic, in the initial stages of lockdown, Connecticut, California, Michigan, Kentucky, New Hampshire, and Louisiana all reported double-digit percentage decreases in reports to child maltreatment hotlines.3PTICoronavirus lockdown. Govt helpline receives 92,000 calls on child abuse and violence in 11 days. The Hindu, April 8, 2020https://www.thehindu.com/news/national/coronavirus-lockdown-govt-helpline-receives-92000-calls-on-child-abuse-and-violence-in-11-days/article31287468.ece#Date accessed: May 21, 2020Google Scholar, 4Calaway J Spike in severe child abuse cases likely result of COVID-19. Cook Children's Checkup Newsroom.https://www.checkupnewsroom.com/spike-in-severe-child-abuse-cases-likely-result-of-covid-19Date: May 6, 2020Date accessed: May 21, 2020Google Scholar, 5LeBlanc P Child abuse reports are down during the pandemic. Experts say that's a bad sign. CNN, May 17, 2020https://edition.cnn.com/2020/05/17/politics/child-abuse-pandemic/index.htmlDate accessed: May 21, 2020Google Scholar These reductions do not reflect decreased incidences of child maltreatment, but unfortunately are a direct result of the precipitous decrease in contact between children, educational personnel, and other community youth programmes. Even if increases in incidence of child maltreatment are short lived, their effects are not. Child abuse and neglect can lead to myriad long-term health consequences, including mental health disorders, sexually transmitted infections, unwanted pregnancies, and substance abuse.6Norman RE Byambaa M De R Butchart A Scott J Vos T The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis.PLoS Med. 2012; 9e1001349Crossref PubMed Scopus (2138) Google Scholar The long-term impact underscores how urgently the current increases in child maltreatment must be recognised and addressed. Monitoring child welfare is an important aspect of education and can be modified for a distance-learning model. Schools should adapt existing child welfare protocols for the pandemic context and retrain teachers to ensure they are equipped to (1) identify at-risk individuals by spotting signs of child abuse and neglect specific to a distance-learning model, (2) use specific language and protocols to ask questions about home experience safely, and (3) report suspected abuse and neglect to appropriate school personnel (eg, headteacher or guidance counsellor) so that abused and neglected children are directed to area-specific support resources. There are clear reasons to return students to in-person learning as expediently as is safe, including minimising lost learning, facilitating economic reopening, and providing safety net protection for children. As schools slowly resume in-person learning around the world, there is no question that many aspects of distance learning are here to stay. Looking ahead, our system must be redesigned, and our teachers and youth programmes trained and supported on identification and intervention of child abuse and neglect in a virtual world. We declare no competing interests. Education: a neglected social determinant of healthEducation and health and wellbeing are intrinsically linked. The evidence behind the importance of education as a determinant of health is amongst the most compelling. Education is strongly associated with life expectancy, morbidity, health behaviours, and educational attainment plays an important role in health by shaping opportunities, employment, and income. In this issue of The Lancet Public Health, two research Articles emphasise the lifelong impact of education on health. The study by Yu-Tzu Wu and colleagues shows that differences in education and wealth established earlier in life were strongly associated with disparities in healthy ageing across a large, multi country cohort of older people. 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