Estimating child maltreatment cases that could be alcohol-attributable in New Zealand
The researchers behind this study point out that much of the quantification of alcohol harm relates to the impact of alcohol on the alcohol user him or herself.
The contribution of alcohol’s harm to people other than the [alcohol user], including children, has largely been excluded from global comparative risk assessments such as the Global Burden of Disease study or the WHO Global Status Report, which underestimates the total impact of alcohol.”Huckle, T., and Romeo, J. S. (2022) Estimating child maltreatment cases that could be alcohol-attributable in New Zealand, Addiction. doi: https://doi.org/10.1111/add.16111.
Indicators of harm to others are therefore urgently needed to provide a more complete picture of the burden of harm to others, to inform decision-making, and to strengthen alcohol policy.
Children have rights to be protected from maltreatment (Article 19 of the UN rights of the child) but are effectively under-protected from the impacts of unhealthy commodities including alcohol.
In this cohort study, researchers studied almost 60,000 children in New Zealand, and followed them and their parents from age 0 to 17 years. 14% of the children had experienced at least one maltreatment event. 6% of the parents had a documented alcohol-attributable hospitalisation or service use for mental health or addiction.
The types of first maltreatment events were:
- Neglect (19%),
- Physical abuse (11%),
- Sexual abuse (9%),
- Family violence in the household (20%),
- Assault (2%), and
- Unspecified (5%).
Analysis show that there was a 65% increased risk of child maltreatment if a child was exposed to parents who had an alcohol-attributable hospitalised or mental health/addictions service use.
The sensitivity analyses estimated that in 2017:
- 14.6% of the documented cases of child maltreatment in New Zealand could be attributable to parents with heavy alcohol consumption.
- 11.4% of the documented cases could be attributable to parents with high-risk alcohol consumption.
Background and aims
Children are an important group harmed by others’ alcohol consumption.
- compared the risk of occurrence of child maltreatment among children exposed vs not exposed to parents with a hospitalisation due to alcohol or service use for mental health/addiction, and
- conducted sensitivity analyses to estimate the cases of child maltreatment that could be attributable to alcohol under two different conditions in New Zealand.
Design, setting and participants
This cohort study was conducted among 58,359 children 0-17 years and their parents (years 2000-2017) using the Statistics New Zealand Integrated Data Infrastructure.
The prevalence of heavy ad high-risk alcohol use among parents was obtained from the New Zealand Health Survey 2017 (n = 13,869).
Survival analysis based on a Bayesian piecewise exponential model was used to estimate the risk of time-to-first substantiated child maltreatment event (identified from social service, hospital, mortality and police data) related to exposure to parents with an alcohol-attributable hospitalisation or who used a mental health/addiction service (vs no exposure).
Potential confounders were included for parents and children. The sensitivity analyses i) estimated an alcohol-attributable admissions/service use fraction for maltreatment in 2017 and ii) calculated a population-attributable fraction using the relative risk from the cohort and prevalence of hazardous drinking (AUDIT 8+) among parents in 2017.
There was a 65.1% increased risk of child maltreatment if a child was exposed to parents who had an alcohol-attributable hospitalization or mental health/addictions service use.
The sensitivity analyses estimated that in 2017 14.6% and 11.4% of the documented cases of child maltreatment in New Zealand could be attributable to parents with heavy or high-risk alcohol consumption.
In New Zealand, exposure to parents with an alcohol-attributable hospitalisation or service use is a risk factor for substantiated child maltreatment.