Abstract
OBJECTIVE: To determine the association between family and domestic violence (FDV) exposure and ED attendance in Australian children. METHODS: The present study comprised a population-based retrospective cohort study using deidentified linked administrative data of children born 1987-2010, in Western Australia (n = 58 352). Multivariate Cox proportional hazards modelling was used to estimate the association of FDV exposure with ED attendance. Estimates are presented as adjusted and unadjusted hazard ratios (HR) with Wald 95% confidence intervals (CI). RESULTS: Children exposed to FDV had a 35% (HR = 1.35, 95% CI: 1.32-1.38) increased risk of ED attendance than non-exposed children. Following model adjustment for sociodemographic and clinical characteristics a statistically significant increased risk of 21% (HR = 1.21, 95% CI: 1.18-1.23) was observed in FDV-exposed children compared to their non-exposed counterparts. When stratified by Aboriginal status, an increased risk for ED attendance was observed in both Aboriginal and non-Aboriginal children exposed to FDV, when compared to non-exposed counterparts (aHR = 1.13, 95% CI: 1.11-1.16; aHR = 1.42, 95% CI: 1.37-1.47, respectively). CONCLUSIONS: Exposure to FDV is associated with an increased risk of ED attendance in childhood. The findings add to the limited literature providing further support that FDV exposure impacts children's health service utilisation and further supports that children's exposure to FDV as an area of public health concern. Attendance at the ED presents an opportunity for intervention.