Berks County Medical Society Medical Record Fall 2021 - 16

mEdiCal rECord FEaturE
Masked Maltreatment:
A Study of Child Abuse
Reporting in Berks
County, Pennsylvania
by Jasmine M. Slusser
Berks County Medical Society 2021 Pat Sharma President's Scholarship Intern
Advisors: Renee Riddle, MD, FAAP, Raymond Truex, MD, FACS, FAANS and Lucy J. Cairns, MD
ABSTRACT
Overview This study is a quantitative and qualitative
examination of child abuse reporting in Berks County during the
COVID-19 pandemic.
Methods This study categorized child abuse as the neglect,
drug-related maltreatment, or physical, mental, or sexual abuse
of a person under the age of 18. All of the data utilized was
specific to Berks County, Pennsylvania. A preliminary analysis
was conducted on child abuse reports made by Tower Health
Reading Hospital employees, abuse statistics from Berks County
Children Services, child fatality and near fatality cases from the
PA Department of Human Services, and expert testimonies from
Berks County child service experts. Additional observations were
made using COVID-19 statistics and county unemployment
rates from the Covid Act Now Coalition and PA Department of
Labor & Industry.
Results This study found conservative decreases in medical
child abuse reports which coincided with an increase in
home visits from public school officials, and a steep decline
in child abuse cases overseen by the Berks County Detectives
Office. Conservative increases in mental abuse, drug-related
maltreatment, and general concerns were documented in
2020 with additional increases in sexual abuse and neglect
during 2021. An increased male to female victim ratio was also
observed. Child fatality and near fatality cases also appeared
to increase during 2020. A potential negative association was
found between medical child abuse reports and the Berks County
unemployment rate, however there was no clear correlation
between child abuse reports and COVID-19 cases. Expert
testimonies posit the extent of COVID-19's effects on child
abuse will be more visible as more victims come forward within
the coming years. These findings, paired with a steady rise in
alleged child abuse incidents in 2021, prompt the need for
16 | w w w .berkscms .or g
further research on the effects of the COVID-19 pandemic on
child abuse reporting.
INTRODUCTION
It is not an understatement to say that children are our
future. The maltreatment of children, including neglect,
and mental, physical, and sexual abuse, can generate both
acute and chronic negative outcomes, which result in societal
repercussions.1,2
at higher risk for developing diabetes, lung disease, arthritis,
and/or high blood pressure.2,3
can also increase specific health risks.2,3
In addition to direct symptoms of child abuse,
including physical, psychological, and behavioral conditions,
several studies have found victims of child maltreatment are also
The type of abuse experienced
For example, neglect has
been linked to vision difficulties, and physical abuse can increase
the risk of malnutrition.2,3
From a psychological perspective, in
addition to physical brain injuries, child maltreatment can lead
to diminished cognitive skills, poor mental health, post-traumatic
stress disorder, and an increased likelihood of perpetrating
maltreatment to others.2,3
Proven protective factors against child
Risks factors
abuse include stable, educated, and employed families, adequate
housing, and exposure to positive role models.4
for child abuse include alcohol and/or drug use by a caregiver,
and the risk of abuse is three times greater for a child with a
disability.4,5
On a more societal level, there have been strong correlations
between victims of child maltreatment and future juvenile
delinquency, criminal activity, substance abuse, and unhealthy
sexual practices.2,3
In the 2018-2019 fiscal year, the total
The CDC has estimated that the national
With at least 1 in 7 children
funding spent for Pennsylvania Child Welfare Services was
$1.894 billion.6,7
lifetime economic burden for child abuse in 2015 was $428
billion dollars with lifetime costs of $831,000 per child and
$16.6 million per fatal incident.6,7
estimated to have experienced child abuse and at least 1,840
deaths nationally from child abuse and neglect in 2019, child
The BCMS Pat Sharma P r esident 's S chola rship
http://www.berkscms.org
Berks County Medical Society Medical Record Fall 2021

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