Childhood abuse is a serious public health issue which puts the child population at risk of developing poor mental health in later life. Low socio-economic status is understood to be a common contributory factor associated with child abuse.

Childhood abuse is a serious public health issue which puts the child population at risk of developing poor mental health in later life. Low socio-economic status is understood to be a common contributory factor associated with child abuse. However it can be defined child abuse can be referred to as any act regardless of background and class that brings harm to a child through the potential caregiver (Spring 2011).
The World Health Organization has defined child maltreatment as being: Write in your own words please
All forms of physical and/or emotional ill-treatment sexual abuse neglect or negligent treatment or commercial or other exploitation resulting in actual or potential harm to the childs health survival development or dignity in the context of a relationship of responsibility trust or power. (Butchart et al 2006 p.59)
Furthermore child abuse has been a serious issue for several years with many people finding the very notion of children being maltreated very difficult. Furthermore child abuse is a substantial social problem with over 8395 cases reported in 2015 by the Statistics Portal (2015). This abuse has implications for the child the family and society itself. While personal and familial costs are more obvious social expenses are potentially also detrimental with a huge financial burden placed on the child welfare system. It requires vast amounts of time and money to identify substantiate and prosecute cases of abuse. Additional funding is required to remove and provide placements for abused children. However as was made known by Caroline et al (2012) most cases of child abuse are not reported which makes it difficult to get an accurate estimate of those children that are going through one type of abuse or the other. Nevertheless a report by the National Society for the Prevention of Cruelty to Children (NSPCC) indicates that about 16% of children in the United Kingdom suffer some form of abuse in their lifetime. Hibbert and Bradshaw (2001) also highlight the high prevalence of both physical and emotional abuse.
In addition the World Health Organization (2002) has confirmed that the highest rates of fatal child abuse are found among children aged 0-4 years; and the most common cause of death is head injury followed by abdominal injuries and intentional suffocation. Infants and young children who are small and in need of constant care are at risk of experiencing certain forms of maltreatment such as being shaken by parents or caregivers who may be frustrated or overwhelmed by persistent crying (American Psychology Association 2016). Teenagers on the other hand are at greater risk of being sexually abused and undoubtedly children with physical cognitive and emotional disabilities or chronic illnesses may be at risk of abuse at some point in their life in that they may experience maltreatment from a parent or caregiver. As a result of their childs health predicament a parent or caregiver of such a child are more likely to be stressed depressed and angry (American Psychology Association 2016).
Millions of children are victims of non-fatal abuse and neglect. Some studies according to WHO (2002) indicate that between one-quarter and one-half of children report severe and frequent physical abuse including being beaten kicked or tied up by parents. Available data also suggests that about 20 % of women and 5-10 % of men suffered sexual abuse as children.
Out of 15 European countries Home Office figures show that Finland has the highest child homicide rate Scotland has the second-highest rate and Northern Ireland the fourth-highest while England and Wales rank eighth in this list. Austria has the lowest rate at 0.64 child homicides per 100000 of the population (Home Office 2010). Babies under the age of 12 months have the highest homicide rates of any age group in England and Wales with a rate of 27 per million compared to 12 per million in the general population as reported in 2008-9 (Home Office 2010).
Policy analysts confirm that the UK ranks at the bottom of the league for measures aimed at ensuring child wellbeing compared with other countries in Western Europe (UNICEF 2007) and that children in Britain today have more challenging lives than previously (Layard and Dunn 2009). However while overall child wellbeing indicators for the UK compare unfavourably with other countries in Western Europe indicators of child maltreatment used in international comparisons have been limited to homicidal rates for which the UK is by no means performing the worst (Smith et al 2010; UNICEF 2003; UNICEF 2007).
According to the National Society for the Prevention of Cruelty to Children (NSPCC 2016) there are various different types of child abuse including emotional abuse physical abuse bullying and cyberbullying domestic abuse child trafficking female genital mutilation (FGM) child sexual exploitation and others.
There is a substantial amount of harsh punishment in the form of hitting punching kicking or beating which occurs in homes and other institutions; but children are also subjected to psychological or emotional abuse as well as neglect though the true extent of these problems are not known and deaths might just be the tip of the iceberg in terms of this problem.
It has been established that there is a strong correlation between child abuse and family income. Researchers and policy makers have long recognized that children from low income families are 10 times more likely to be at risk of maltreatment compared to children of higher social economic status (Cancia et al. 2010). Just as importantly aggression attention deficit issues difficult temperaments and behaviour problems in children may be directly linked with an increased risk of mal-treatment especially when parents have low coping skills or are unable to empathize with the child or to control their own emotions (American Psychology Association 2016). Maltreatment often ex-acerbates the problem and a physically abused child may develop aggressive behaviours that lead to recurring maltreatment.
Research has also found that children living in the most deprived neighbourhoods have a greater chance of being on a child protection plan or being taken into care than children in the least deprived areas (Jutte et al. 2014). Sometimes the services they need just arent available or they arent able to access them. This can put children at a higher risk of harm and research has found that there are clear links between social isolation and child abuse or neglect (Jutte et al. 2014). Socio-economic status (SES) however has been identified as a factor and this is measured as a combination of education income and occupation. It is commonly conceptualized as the social standing or class of an individual or group. When viewed through such a class lens privilege power and issues of control are emphasized. Furthermore an examination of SES as a gradient or continuous variable reveals inequities in both the access to and distribution of resources. SES is relevant to all realms of behavioural and social science including research practice education and advocacy (American Psychological Association 2016).
According to Schowengerdt (1996) research studies on child abuse report on such aspects as socio-economic levels; the characteristics of abuse; demographic factors; and assessment for detection of potential abusers. Characteristics of potential or actual abusers are frequently cited in relation to low socio-economic status. Yet at the same time data indicates that child abuse has no socioeconomic boundaries. There is minimal data reported that would help nurses to identify potential child abusers from higher socioeconomic levels and further study is needed to identify if there are any noticeable differences in the potential for child abuse as measured between parents of low socioeconomic status and parents of high socioeconomic status.
Spring (2011) indicated that single parent households are perceived to be particularly vulnerable to abuse as a result of the high stress of raising a child alone as well as the lack of good income com-pared to more affluent families. Also children raised in a home with a step-parent are at a higher risk of abuse according to spring (2011). Statistics show that children in this category are 40 times more likely to be abused than those who live with both biological parents.
The detrimental effect of child abuse can be both short-term and long term and may result in psychological emotional mental behavioural and physical effects. The latter may include head injury neck and facial injury damage to the torso or death. The United States of America (USA 2015) has also indicated that severe and repeated trauma may have an enduring effect on both neurobiological and psychological development altering the stress response and adult patterns of behaviour considerably; this can include mood changes anxiety and personality issues throughout adulthood.
Avanci (2012) argued that childhood depression affects the morbidity mortality and life functions of children. Individual family and environmental factors have been documented as psychosocial risk factors in childhood depression and family violence is a strong factor leading as it does to in-adequate support low family cohesion and poor communication. Avancis study investigates the association between psychosocial depression factors in low-income schoolchildren and reveals the potential trouble spots highlighting several different forms of violence that can take place within the family context.
A number of studies have explored the relationship between childhood trauma and later health concerns. Research has found that childhood abuse contributes to the likelihood of depression anxiety disorders addictions personality disorders (Spila Makara Kozak & Urbanska 2008) eating dis-orders sexual disorders and suicidal behaviour (Draper et al. 2007). A study by Palmer Brown Rae-Grant & Loughin (2001) with 384 survivors of childhood abuse found that such survivors tended to be depressed have low-self-esteem and to have problems with family functioning as adults. A recent study found that almost 76% of adults reporting child physical abuse and neglect suffer from at least one psychiatric disorder in their lifetime; and nearly 50% have three or more psychiatric disorders (Harper et al. 2007). Adults with abuse histories also present with physical problems more frequently than those who have not experienced abuse (Draper et al. 2007). Furthermore child sexual abuse has been found to be a key factor in youth homelessness with 50-70% of young people within Supported Accommodation Assistance Programs having experienced child-hood sexual assault (van Loon & Kralik 2005b). Research shows that children and adults with histories of child abuse often respond excessively to minor triggers. Traumatised children (and adult survivors) become increasingly responsive to relatively minor stimuli as a result of decreased frontal lobe functioning (learning and problem-solving) and increased limbic system (amygdala) sensitivity (impulsiveness) (Streeck-Fischer & van der Kolk 2000).
It has been suggested that a framework of prevention strategies and services before abuse and neglect can occur need to be developed (Draper et al. 2007. alongside remedial strategies. Child abuse survivors Draper suggests demonstrate poor mental health outcomes and they are more likely to be depressed in later life as well as being at risk of developing poor physical health. Draper stressed further that a child experiencing abuse is at increased risk of medical diseases on reaching adult-hood including cardiovascular events in women. Survivors tend to face a higher risk of broken relationships and experience a lower chance of marriage in life. It is also recognized that abuse is associated with behavioural health effects including increased likelihood of smoking substance abuse physical inactivity and suicidal behaviour. The impact of child abuse does not end when the abuse stops and the long-term effects can interfere with day-to-day functioning. However it is still possible for a child abuse survivor to live a full and constructive life and even thrive to enjoy a feeling of wholeness satisfaction and fulfilment in work and genuine love and trust in relationships. Understanding the relationship between prior abuse and current behaviour is known to be the first step towards recovery.
Over two decades of research have demonstrated the potential negative impacts of child abuse and neglect on mental health including: depression anxiety disorders poor self-esteem aggressive behaviour eating disorders use of illicit drugs and alcohol abuse post-traumatic stress disorder sexual difficulties self-harming behaviours and personality disorders. Survivors are also more likely to commit crimes as juveniles and adults.
The Child Welfare Information Gateway (2013) argued that there is a significant body of ongoing research on the consequences of child abuse and neglect. The effects vary depending on the circumstances of the abuse or neglect personal characteristics of the child and the childs environment. Consequences may be mild or severe; disappear after a short period or last a lifetime; and affect the child physically psychologically behaviourally or in some combination of all these ways.