Is the cluster risk model of parental adversities better than the cumulative risk model as an indicator of childhood physical abuse?: Findings from two representative community surveys
In order to improve identification of children at risk of childhood physical abuse (CPA) screening strategies need to be improved. This study compares cluster (the type of risk factors is key) and cumulative (the number of risk factors is key) models of risk indicators (i.e., parental divorce, parental unemployment, substance addiction). Data were drawn from Statistics Canada National Population Health Survey (NPHS) (1994-1995) and Canadian Community Health Survey (CCHS) 3.1 (2005). Participants aged 18 and over who answered questions about childhood experiences.
The prevalence of CPA for respondents from CCHS who did not report any of the three selected risk indicators was 3.4%, and was also 3.4% for risk-free respondents from NPHS. The prevalence of CPA for who experienced parental divorce only was 8.3% (CCHS) and 10.7% (NPHS); for respondent who had experienced parental unemployment only the prevalence of CPA was 8.9% and 9.7% respectively.; and for those who had experienced parental substance addiction alone the prevalence of CPA increased to 18.0% (CCHS) and 19.5%(NPHS). The presence of all three risk indicators increased the prevalence of CPA to 36.0% and41.0%.
Authors conclude that a cumulative model is a better option as a first-stage screening tool in order to identify CPA. Rather than physicians solely assessing the physical and trauma-related injuries associated with abuse, in order to gain more insight into the potential for CPA doctors are encouraged to inquire about parental substance addiction, parental unemployment, and parental divorce.