Berks County Medical Society Medical Record Fall 2021 - 17

maltreatment poses a serious public health issue.1,8
Therefore, it
is both medically and politically essential to examine the health
determinants and the consequential well-being of children, especially
during the COVID-19 pandemic.
In Pennsylvania, the Child Protective Services Law defines
child abuse as any sexual abuse or sexual exploitation, serious
neglect, or recent act or failure to act by a perpetrator which causes
nonaccidental serious physical injury or non-accidental serious
mental injury to a child under 18 years of age.9,10
A perpetrator is
defined as an individual over the age of 14 who is responsible for
the welfare of a child.9,10
While everyone is encouraged to report
any suspicion of child maltreatment, mandated reporters are legally
required to do so, due to their professional or voluntary contact
with children. In Pennsylvania, three main sectors of mandated
reporters are (1) educational faculty and staff/childcare providers, (2)
law enforcement and social workers, and (3) medical providers and
healthcare workers.6
programs.
LITERATURE REVIEW
Past studies found undesirable economic situations, specifically
periods of high job loss, are associated with increased incidence of
child maltreatment.10
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household income and access to resources, financial uncertainty, and
debt which can lead to foreclosure.12,13,14,15
Other economic stressors include decreased
Such stressors can result
in parental burnout, defined as when needs are greater than available
resources, which increases parental likelihood to participate in child
abuse and neglect.16
Indeed, child abuse was found to significantly
increase during the Great Recession of 2007-2009.17
Similar to other natural disasters and traumatic events, such as
famine, war, and extreme weather events, COVID-19 has also posed
many risks to psychological well-being. Increases in anxiety and
stress during the pandemic are commonly attributed to concerns
about COVID-19 infections, following proper safety protocols,
caring for a sick individual, and/or the death of a loved one.16,18
Pandemic-related psychological stress, similar to the economic
stressors mentioned above, increases the likelihood of a parent or
guardian purposely or inadvertently engaging in child abuse and
neglect.18
Such conditions,
specifically increased exposure to family, may have triggered or
worsened psychological conditions such as anxiety, depression, and
stress which correlate with child abuse.13,16,19
Studies have found
when parents are subjected to intensified physical, psychological,
and financial hardships present in natural disasters, parents were
more likely to engage in child abuse and neglect.20,21
These stressors
presented in natural disaster settings have been shown to heighten
the incidence and severity of both child abuse and domestic
violence.18
14.2% decrease in child abuse reports in March of 2020, 40.6% in
April 2020, and 35.1% in May 2020.22
Preliminary statistics from national news agencies projected a
One study found private
child abuse hotlines also observed a significant decrease in call-in
reports during April, especially by school reporters, which gradually
increased around May 2020.23
In contrast to news reports, both call
and text hotline reports made in May 2020 went on to significantly
exceed the weekly report totals made in 2019.23
continued on next page
4/21
F ALL 2021 | 17
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These psychological stressors were exacerbated as lockdown
conditions limited access to childcare and social support systems
and increased exposure to immediate family. 13,16,19
Service
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Jeff Schatz, Owner/President
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Berks County Medical Society Medical Record Fall 2021

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