Intimate partner violence as a risk factor for children's use of the emergency room and injuries

This study examined the associations between intimate partner violence (IPV) and children's use of the emergency room (ER) for an illness or injury, and care of the child by a doctor or nurse for a serious injury, accident or poisoning. We hypothesized that a mother's mental health (depression, alcohol abuse and drug abuse) and a child's lack of supervision would mediate these associations. Data were from the National Survey of Children and Adolescent Well-Being (NSCAW), a national probability study of children investigated for abuse and neglect. The analysis was limited to 2929 female caregivers who were the biological, adoptive, or stepmothers of the children. Exposure of the mother to current severe intimate partner violence was positively associated with children's use of the ER. There was no association between maternal current or past exposure to IPV and children's injuries. Current moderate IPV, current severe IPV and past severe IPV were significantly and positively associated with maternal depression. Maternal depression was not associated with child's lack of supervision. However, maternal alcohol abuse and drug abuse were positively associated with child's lack of supervision. The relationship between IPV and children's use of the ER was mediated by matemal depression. Maternal depression and lack of supervision of the children were positively associated with children's injuries. Identification of maternal IPV and depression during children's ER visits can help guide services to prevent future use of the ER and injuries to children. (c) 2005 Elsevier Ltd. All rights reserved.