Chronic conditions in children increase the risk for physical abuse – but vary with socio-economic circumstances


Birgitta Svensson, Division of Public Health Science, Department of Health and Environmental Sciences, Karlstad University, 651 88 Karlstad, Sweden.
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Aim:  To explore whether children (age 10, 12 and 15 years) with self-reported chronic conditions are at higher risk of physical abuse and/or exposure to intimate-partner violence than other children, while considering the importance of demographic factors.

Methods:  A national cross-sectional study of 2771 pupils in grades 4, 6 and 9 from 44 schools in Sweden (91% response rate). Conflict Tactic Scales were used to measure physical abuse and separate questions measured exposure to intimate-partner violence. A list of 13 diagnoses was used to estimate chronic conditions.

Results:  Children with chronic conditions had an increased risk for physical abuse (CPA) only (OR 1.67) as well as in combination with exposure to intimate-partner violence (IPV) (OR 2.54), but not to IPV only, compared to children without chronic conditions. Furthermore, when chronic conditions were combined with country of birth other than Sweden and living in low-income areas, the risk for CPA increased even more, indicating interactive effects.

Conclusions:  A wide range of chronic health conditions in children increased the risk for physical abuse. This indicates that certain factors unite this group of children, irrespective of the type of disability or degree of severity, but where a combination with socio-economic circumstances is of importance.