Summary

The National Plan to End Violence against Women and Children 2022–2032 highlights the importance of recognising children and young people as victim-survivors of violence in their own right and to establish supports and services that will meet their safety and recovery needs (DSS 2022). In light of this, the focus of this report is children and young people who have experienced family and domestic violence (FDV), and their health service interactions (both FDV- and non-FDV-related). This was achieved through the use of longitudinal, linked data from the National Health Data Hub (NHDH). The datasets analysed within the NHDH include emergency department and admitted patient care data, Medicare Benefits Schedule data, and the national death index. Understanding how children and young people who experience FDV interact with the health care system, as well as their outcomes, provides evidence for potential intervention and screening points.

The population studied in this report includes young people who had at least one FDV hospital stay (defined as an assault due to a family member or partner) from 2010–11 to 2020–21, while aged under 18 years (referred to as the FDV group). This report presents information on their demographic characteristics, such as age at first FDV hospital stay, sex and Indigenous status, and the identified relationship to the perpetrator of the assault. It also examines, where relevant, their emergency department presentations, the total number and types of diagnoses associated with all-cause (any diagnosis) hospital stays, use of Medicare-subsidised services, and causes of death.

To assist with the interpretation of the results, where relevant, analyses are presented for either the Australian population aged under 18 years, or a more specific comparison group consisting of individuals with at least one injury-related hospital stay, who did not have any FDV stays, while aged under 18 years over the same period. This comparison group was constructed using stratified random sampling, matching on age, sex, Indigenous status, year of first hospital stay and remoteness area, at a 1:4 ratio (for every one FDV case, there were 4 matching control cases selected).

From 2010–11 to 2020–21, 5,024 young people had at least one FDV-related hospital stay while aged under 18. This equates to one child per day having an FDV-related hospital stay.

Among the 5,024 who had an FDV-related hospital stay:

  • just over half (54%) were female and the remainder were male (46%)
  • around one-third (33%) were Aboriginal and Torres Strait Islander people
  • over one-third (37%) had their first FDV hospital stay before the age of 5.

Males were typically younger than females, at first FDV hospital stay.

Most commonly, the first FDV hospital stay occurred as a baby (before age one) (18% of the FDV group). A further 19% of people in the FDV group had their first FDV hospital stay between the ages of 1 and 5.

Within the FDV group, males were more likely than females to have their first FDV hospital stay as a baby (before age one) (21% of males compared with 14% of females), while females were more likely to have their first FDV hospital stay as a teenager (while aged 13-17) (53% of females compared with 35% of males).

Parents were the most common perpetrator recorded.

Of all FDV hospital stays, 62% were due to a parent perpetrator (see box 5 for definitions) and 25% were due to another family member. Among the FDV group, males (99%) were more likely than females (83%) to have a family member (including a parent) as the perpetrator, while females (21%) were more likely than males (2%) to have a partner perpetrator. This pattern is consistent with age at FDV hospital stay patterns–with males being younger on average (and therefore less likely to be of an age to have a partner).

Pregnancy-related hospital stays were more common among the FDV group.

Two of the top 5 principal diagnoses for all-cause hospital stays among the FDV group were pregnancy-related. It is important to note that these are not necessarily pregnancies that occurred when aged under 18, due to the cohort selection method: for example, if a person experienced an FDV stay in 2010–11 while aged 17, they are included in the study, despite being an adult during the remainder of the measurement period (up to 2020-21).

There were no pregnancy-related diagnoses in the top 5 principal diagnoses for the comparison group.

1 in 18 people in the FDV group had two or more FDV hospital stays from 2010–11 to 2020–21.

Of the FDV group, 5.6% had 2 or more FDV hospital stays in the 11-year period. Of those with repeat FDV hospital stays, most were female (69%).

Young people in the FDV group had more ED presentations than the comparison group.

On average, young people in the FDV group had around 10 (10.5) emergency department (ED) presentations per person while the comparison group had just under 8 per person (7.9).

About one in 2 (52%) people in the FDV group who had multiple FDV hospital stays had 11 or more ED presentations.

The rate of, and age at, death were similar for the FDV group and the comparison groups, however the leading causes of death differed.

Just under 1% of both the FDV group and the comparison group had a death recorded in the measurement period (0.8% and 0.7%, respectively). Around 1 in 4 deaths occurred under age 2 years (24% and 25%, respectively). The leading cause of death among the FDV group was assault (27% of deaths) while the leading cause of death among the comparison group was suicide (19%). Suicide is the leading cause of death among young people nationally (AIHW 2024a).