Atlanta
(2005-02-16)
CDC: Time to Expose “Hidden Problem” of Child Abuse
Dr. Jim Mercy
Experts are also trying to create more effective ways to halt abuse and neglect of children.
WABE's Ted Vigodsky recently spoke about the issue with Dr. Jim Mercy - the Associate Director for Science in the CDC's Division of Violence Prevention, at the National Center for Injury Prevention and Control.
WABE: How many children would the CDC estimate are abused or maltreated each year?
JIM MERCY: Child maltreatment is a hidden problem. It's largely hidden from view. We know from data from child protective service agencies that in 2002 about 896,000 children wereconfirmed as victims of child maltreatment. But other data suggest that that may be an underestimate of a magnitude of ten.
WABE: How preventable do health officials think this problem is?
JIM MERCY: We think it's very preventable and we even have examples of interventions that have been successful in preventing child maltreatment.
WABE: The A.C.E. study, the Adverse Child Exposure study what made that such a significant study and how has it been used since it came out?
JIM MERCY: Not only is the magnitude of the problem of child maltreatment hidden but also the consequences of child maltreatment largely hidden from view and what this study and many other studies are showing is that exposure to child maltreatment increases the risk for things like smoking, substance abuse, obesity, alcohol use, depression and in turn also increases the risk of disease such as cancer, heart disease, stroke and many other factors like that. So, child
maltreatment may have a broad impact on the health of the children as they grow older. There are a range of adverse exposures during childhood including witnessing violence in the home, child maltreatment, as well as living with a parent who is a substance abuser or who has a criminal history. But even though that was the focus of the ACE study, other research suggests these same consequences of risk behaviors and disease are associated with child maltreatment.
WABE: Apparently what was also good about this study, they were able to stratify or quantify things with great specificity.
JIM MERCY: Yeah, plus they were able to show a dose-response relationship so the more these adults were exposed to maltreatment as children and other adverse exposures, the greater the likelihood of having disease in adulthood or engaging in unhealthy behavior.
WABE: Let's talk a little bit about interventions. Something that's been around for awhile I understand but it's probably being refined home visitation. How does that work?
JIM MERCY: This is an intervention where typically nurses or other para-professionals visit the homes of families at high risk of child maltreatment either families in which the mom is a teenage mother or a young mother or a single parent or otherwise at risk you would put in a high risk group for child maltreatment. And they'd provide help to that parent in terms of helping them think through how to best discipline their child, how to keep the home environment safe, how to help the mother gain access to social services, provide a lot of support and information to that mother which have been shown to help reduce child maltreatment. We're very interested in looking at what we call population-based parenting programs which help and support parents in a variety of ways and meet the variety of needs that parents have.
Parenting is a tough job, we all know that, and all of us can benefit as parents particularly when
we're in stressful situations with work or having experienced a divorce. And these types of programs provide general information through the media on good parenting practices, how to discipline your child, where to get them help and social services, as well as more targeted interventions for parents who are having extreme problems in managing the behavior of their child or keeping from maltreating their child as well as interventions for doctors and pediatricians to help provide them with information they can give to their patients and the parents that they interact with to help them better manage their children and avoid maltreating them.
WABE: Now, CDC like other federal agencies may be facing some big cuts. Are you concerned that there will be enough resources at the federal level to help the states and localities get a handle on this problem?
JIM MERCY: We believe that issues like parenting have cross cutting implications for public health. We believe that there will be strong support for parents and intervening with parents and helping them do a better job of parenting so as to reduce maltreatment so we're confident of that.
WABE: These studies, they've been out a few years now, long enough to get a trend line on how effective they are?
JIM MERCY: I think we know from some of these studies that home visitation programs can be effective but it's hard to say that at this point in time that proliferation of these programs has resulted in a decrease in child maltreatment. For one thing it's so hard to measure child maltreatment and we don't have good systems which can tell us over time whether child maltreatment is increasing or decreasing . So until we can establish those good data systems to monitor the problem it's going to be difficult to answer that question.
WABE: If it is increasing, do you want to hazard a guess what might be making it worse if it is getting worse?
JIM MERCY: One thing is the increasing stress on parents as more demands are placed on them in the workplace, the increase in divorce rates in our society, all these things put increasing stress on parents and their ability to, to raise children in a healthy developmentally appropriate way; that we need to be more vigilant in helping to support parents in ways that prevent child maltreatment.
WABE: Thank you, Dr. Mercy. Here's what we do know about close to a million case reports recently compiled by the federal Administration for Children and Families:
Over half of child maltreatment victims suffered neglect including medical neglect; around a fifth were physically abused; ten per cent were sexually abused and seven per cent were emotionally or psychologically abused; 1,300 died from maltreatment. Over a third of these deaths were from neglect and over a quarter were from physical abuse. A recent CDC study found that infants are at greatest risk of homicide during their first week of infancy with the risk being highest on the first day of life.
Suggest Links
National Parenting Leadership
Month
CDC Child Maltreatment Fact Sheet
American Academy of Pediatrics
National Clearinghouse on Child Abuse and Neglect Information
If you or someone you know is the victim of child abuse or neglect and needs help, contact these organizations for free confidential information:
STOP IT NOW! 1-888-PREVENT (773-8368)
Childhelp USA National Child Abuse Hotline, 1-800-4-A-CHILD
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