Children who have suffered sexual abuse are now going to the ER at much higher rates compared to a decade ago, according to research from St. Louis University.

The national rate of ER admissions for child sex abuse nearly doubled between 2010 and 2016. At the same time, cases of confirmed child sex abuse in the U.S. have been declining since the 1990s, according to data from the National Data Archive on Child Abuse and Neglect.

“All the trend lines have shown the rates of child sexual abuse going down,” said Jesse Helton, a professor of social work at St. Louis University. “But for emergency departments, it's been climbing."

He described child sexual abuse as a serious public health issue that sometimes goes unnoticed.

“These are kids who are in your schools, your churches and your neighborhoods,” said Helton, a study co-author.

The research team analyzed a massive dataset of children and teenagers admitted to U.S. emergency rooms from 2010 to 2016.

Nearly 47,000 were admitted to the ER for confirmed sexual abuse over the six-year period. Of these, about 85% were girls, and almost half were adolescents ages 12 to 17.

The analysis also revealed some surprising trends.

The rate at which kids were admitted to the ER for sex abuse nearly doubled, from 6.93 admissions per 100,000 children in 2010 to 11.97 per 100,000 children in 2016.

Treating sex abuse victims in the ER

So, why are more children going to the ER for treatment?

One possibility, Helton said, is greater awareness of sexual assault among health care workers — as well as improvements in care for victims.

“It could be that emergency departments are getting better at collecting the proper forensic evidence and having social workers and specialized physicians available,” he said. “Then communities know that they can go there for these services.”

Because the trend was driven mostly by a growing proportion of adolescent girls seeking treatment, it’s also possible that sex trafficking is to blame. Sex trafficking has become increasingly common in recent years, according to the United Nations, and the “vast majority” of victims are women and girls.

Regardless of the reasons for the increase, more children are now relying on emergency rooms for treatment after sexual assault — and that could pose a problem for hospitals.

Emergency rooms may not be equipped to provide care for child sex abuse victims who are processing complex physical and emotional trauma. Still, the ER may be the only option for children in some communities, Helton said.

“These kids are showing up in emergency departments more than they used to,” he said. “We need physicians to be aware of that and get the right training.”

To report child sexual abuse, call the National Child Abuse Hotline at 1-800-422-4453 or visit childhelp.org. Missouri residents can also contact the state's Child Abuse and Neglect Hotline at 1-800-392-3738.

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