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Parental offending and children’s emergency department presentations in New South Wales, Australia
  1. Tyson Whitten1,
  2. Melissa J Green1,2,
  3. Kristin R Laurens1,3,
  4. Stacy Tzoumakis4,
  5. Felicity Harrs1,
  6. Vaughan Carr1,2,5,
  7. Kimberlie Dean1,6
  1. 1 School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
  2. 2 Neuroscience Research Australia, Sydney, New South Wales, Australia
  3. 3 School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
  4. 4 School of Social Science, University of New South Wales, Sydney, New South Wales, Australia
  5. 5 Department of Psychiatry, Monash University, Clayton, Victoria, Australia
  6. 6 Justice Health and Forensic Mental Health Network, Matraville, New South Wales, Australia
  1. Correspondence to Professor Kimberlie Dean, School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia; k.dean{at}


Objectives Children whose parents have a history of criminal offending may be at risk of higher rates of emergency department (ED) presentation, along with other adverse health outcomes. We used data from a large, population-based record linkage project to examine the association between maternal and paternal criminal offending and the incidence of ED presentations among child offspring.

Methods Data for 72 772 children with linked parental records were drawn from the New South Wales Child Development Study. Information on parental criminal offending (spanning 1994–2016) and child ED presentations (spanning 2005–2016; approximately ages 2–12 years) was obtained from linked administrative records. Cox proportional hazards regression analyses were conducted to examine the association between parental offending and the incidence of children’s ED presentations for any reason and for physical injury, while accounting for important covariates.

Results Child rates of ED presentation, particularly for physical injury, were higher among those with parental history of criminal offending, after adjusting for covariates. The magnitude of the association was higher for paternal criminal offending (ED presentation for any reason: HR=1.44 (95% CI 1.41 to 1.48); physical injury: HR=1.70 (95% CI 1.65 to 1.75)) than maternal criminal offending (any reason: HR=0.99 (95% CI 0.95 to 1.03); physical injury: HR=1.05 (95% CI 1.00 to 1.10)).

Conclusion Children of parents, particularly of fathers, with a history of criminal offending have an increased incidence of ED presentation, including for potentially avoidable physical injury. These findings require replication and further research to understand the mechanisms underlying these associations.

  • injury
  • child health
  • cohort studies

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  • Contributors TW conducted the analyses, interpreted the findings and drafted the initial manuscript. MJG, KRL, ST, FH and VC all coordinated and supervised data collection, research methodology and reviewed the manuscript. KD provided a substantial contribution to the conception and design of the study, interpretation of the findings, and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding This research was conducted by the University of New South Wales with financial support from the Australian Research Council (Linkage Project (LP110100150), with the NSW Ministry of Health, NSW Department of Education, and the NSW Department of Family and Community Services representing the Linkage Project partners; Discovery Project (DP170101403); and Future Fellowship (FT170100294) to KRL); the National Health and Medical Research Council (NHMRC Project Grants APP1058652 and APP1148055 and NHMRC Partnership Project 1133833); and the Australian Rotary Health (Mental Health of Young Australians Research Grants 104090 and 162302).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This research was conducted with ethical approval from the NSW Population and Health Services Research Ethics Committee (PHSREC AU/1/289807 and PHSREC AU/1/1AFE112), and data custodian approvals granted by the relevant government departments. All procedures contributing to this work comply with the Helsinki Declaration of 1975, as revised in 2008.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

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