Keeping Every Child Safe

It’s a problem that hides in the shadows, not fully revealing itself until a child is seriously injured or killed.

Is there a way to protect children before abuse takes place?

Child abuse and maltreatment takes many forms, including physical, sexual, and emotional abuse, as well as neglect. It can have devastating, lifelong consequences. Children who are abused are more likely to experience teenage pregnancy, substance abuse, interpersonal violence, depression, and suicide, along with STDs, obesity, heart ailments, and other health problems. And children who are abused may grow up to be abusers themselves.

EDC research suggests a major shift in focus, strategy, and approach among state health officials, who have begun to treat child abuse as a public health problem—one that can be prevented.

“Children growing up in families that are living in poverty, or where there’s substance abuse or violence, are exposed to more risk factors,” says Sally Fogerty, who leads the Children’s Safety Network at EDC.

According to Fogerty, prior to the late 1990s, most state agencies responded to at-risk situations only after they’d reached a crisis point. “Children were typically identified by the Department of Social Services at the point of abuse or neglect, and then states intervened to prevent further abuse from occurring,” she says.

Children who are deprived of a healthy, safe start in life may grow up to be adults who need increased medical care or are incarcerated for substance abuse, prostitution, acts of violence, and other crimes.

“Now there’s an increased focus on the protective factors,” Fogerty says. “How can we identify families and children who are at greater risk? How can we strengthen families and help them create safe, stable, nurturing homes for children?”

States’ commitment to families

EDC is participating in the Public Health Leadership Initiative, a three-year program led by the CDC Foundation with funding from the Doris Duke Foundation and the National Center for Injury Prevention and Control. The initiative is working with states to identify best practices and model programs that successfully recognize and intervene in families where children may be at risk of being harmed. These may be home visiting programs such as the Nurse-Family Partnership or screening for domestic violence in Women, Infant, and Children (WIC) nutrition programs.

The first step was to conduct an “environmental scan” of all 50 states and Washington, D.C.“We asked how states worked with their child welfare programs, and whether or not their state had a strategic plan to prevent child maltreatment,” Fogerty says. “We also asked about other programs they may be providing, such as maternal depression, shaken baby prevention, and fatherhood programs.”

One hundred percent of the survey recipients responded, and “the results are encouraging,” says Fogerty. They reveal that significant collaboration is occurring between state public health agencies and other agencies on behalf of children’s well-being. States show some inclination to see child maltreatment prevention as a public health issue and to begin to utilize a public health model to address this complex issue.

“We’re doing case studies in five states with successful programs in place—Alaska, Oklahoma, Minnesota, North Carolina, and Florida—to identify the core components,” Fogerty says. “The goal of the Centers for Disease Control and Prevention is to provide all states with the tools they need to develop leadership in this area.”

An expert panel will meet in late July to review both the survey results and case study information to develop the next steps. The full study will be made public at that time.

Focusing on prevention has an added value: It avoids further strain on our nation’s health care, social services, and criminal justice systems by helping children grow up safe and healthy, and to stay on the right path, says Fogerty.

“The goal is to keep every child safe,” Fogerty says. “Creating healthier kids creates healthier adults.”