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Around the Columns

For the children


Because of MU’s research on child maltreatment, Missouri’s child protection programs are national models Photo by Blake Dinsdale.

Epidemiologist Patricia Schnitzer continues cranking out results as part of a long-running research program at MU. The program not only has helped abused and neglected Missouri children, but also led to statewide child-protection programs that serve as models for other states. 

Nearly 20 years ago, the team’s early work launched a first-in-the-nation system of county panels that review all child deaths and help prevent others, says Schnitzer, assistant professor in MU’s School of Nursing. Later research debunked a myth about who maltreats children. “The adage is that kids in households with single moms are at increased risk for abuse and neglect,” Schnitzer says. “But there was no increase in maltreatment deaths in households with just one biological parent.” Instead, the hazard to children rises when a single parent lives in households with other adults, particularly unrelated ones. 

Schnitzer’s research now focuses increasingly on prevention. The latest work looks at children up to age 5 who visited an emergency room (ER) for an injury. She wanted to know how many ER visits for an injury occur before physicians report the case to Missouri social services officials. To find out, she linked hospital billing data for 50,000 ER
visits statewide with data on reports to Missouri’s Department of Social Services. 

It turned out that each visit increases the likelihood of a report. Children with two injury visits were almost twice as likely as kids with one visit to have a report, Schnitzer says. Those with three visits were two-and-a-half times more likely, and kids with four or more are almost four times more likely. “A lot of these are unintentional injuries related to small children who are not properly supervised and who are living in a less-than-safe environment,” she says. 

The upshot, Schnitzer says, is that when young children come frequently to ERs for injuries, the family should be looked at more closely. 

“It’s not necessarily that they are hurting the child, but maybe that they need support or advice to protect their child from those dangers.” Helping families get the support they need protects children, Schnitzer says. It’s that simple.