The epidemiology of violence against children in England, 1971-2024: A longitudinal ecological analysis of 1.7 million care entries

BACKGROUND: Violence against children (VAC) is a major public health concern, yet persistent measurement challenges limit understanding of its epidemiology. Routinely collected administrative data, such as children entering care, represent an underused resource for measuring a subset of VAC serious enough to trigger state intervention. However, national analyses using these data have not been comprehensively updated since 2016, leaving evidence gaps. METHODS: We integrated historical data from the iCoverT database (1971-2016) with recent Department for Education releases (2011-2024) to construct and analyse a 50-year national time series of children entering care in England. From 2011 to 2024, generalised estimating equations compared trends by reason for care entry, legal pathway, sex, and age. Geographic variation was examined across nine regions and 146 local authorities, and associations between child poverty and care entry for child protection reasons were assessed. RESULTS: Abuse and neglect were consistently the dominant reason (56-64%) for care entry. Between 1971 and 2005, care entry rates declined by 1.34% annually (95%CI:-1.53, -1.14), before reversing in 2005. From 2005 to 2024, rates increased by 1.20% per year (95% CI:0.68, 1.73), reaching 33100 new care entries in 2024 (250.0 per 100000 children). Recent increases were driven by entries for child protection reasons and emergency legal pathways, with disproportionate increases among males and adolescents. Marked geographic inequalities were observed, with higher rates concentrated in deprived local authorities; however, short-term changes in child poverty did not explain year-to-year variation in care entry for child protection reasons. CONCLUSIONS: This study identifies a sustained reversal in long-term declines in children entering care in England since the mid-2000s. Considerable inequalities were observed across age, sex, and place. These findings underscore the need for long-term preventive policies addressing structural disadvantage alongside national responsive measures protecting children during periods of economic and societal disruption.