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Public Health Child Maltreatment
by
Joanne Martin

Introduction

Child maltreatment encompasses all forms of child abuse and neglect. Child maltreatment has long-term devastating consequences, and it is preventable. Children die of abuse and neglect at a rate of 2.33 per 100,000 children. Shaken baby syndrome results in blindness, motor and cognitive impairment, and death. Chronic abuse and neglect during infancy and young childhood interferes with brain formation and function Child maltreatment increases the risk of chronic diseases during adulthood. Child maltreatment is a form of violence. Public health starts with the assumption that violent behavior and related adverse consequences can be prevented. The public health approach moves from problem to solution by (1) systematically gathering data on what is known about the scope and consequences of child maltreatment; (2) determining the causes of child maltreatment and what increases and decreases risk factors for abusive and neglectful behavior; (3) discovering ways to prevent child maltreatment by designing, implementing, and evaluating interventions; and (4) disseminating promising and proven interventions to prevent child maltreatment in diverse communities. Violence is the intentional use of force or power and includes threats, intimidation, and neglect. The World Health Organization categorizes violence as self-directed, interpersonal, and collective. Interpersonal violence includes community violence and family violence. Community violence includes youth violence, gangs, sexual violence, and violence in settings such as schools and workplaces. Family violence includes child abuse, intimate partner violence, and elder abuse. Violence is complex and best understood within an ecological framework. First proposed by Urie Bronfenbrenner, the ecological model illuminates the interactions among individual characteristics, social relationships, community context, and societal factors. Public health interventions include primary prevention (before child maltreatment occurs), secondary prevention (immediate response to child maltreatment), and tertiary prevention (reducing long-term consequences resulting from child maltreatment). Approaches to prevent child maltreatment include interventions that are universal, selected, and indicated. Universal interventions are designed for the general public regardless of level of risk. Selected interventions are directed toward persons who are at increased risk of abusing or neglecting children. Indicated interventions are for persons who already have experienced child maltreatment.

General Overviews

Many resources relating to violence and violence prevention are available on the Internet. However, three websites stand out as being authoritative, comprehensive, and up-to-date: Centers for Disease Control and Prevention, World Health Organization, and Centre for Public Health, Liverpool John Moores University. Accessing these websites is recommended as a first step for persons who are interested in child maltreatment as well as the broad topic of violence prevention. Chalk and King 1998 provides in-depth information about family violence and child protection policy and practice. Haskins, et al. 2007 makes recommendations to improve child protection services. Landy and Menna 2006 is a comprehensive resource for working with multi-risk families. Berlin, et al. 2005 puts child maltreatment in the context of early child and caregiver relationships. Jordan and Sketchley 2009 provides a public health framework for preventing child maltreatment, focusing on children from birth to age three.

  • Berlin, Lisa J., Y. Ziv, L. Amaya-Jackson, and M. Greenberg, eds. 2005. Enhancing early attachments: Theory, research, intervention, and policy. New York: Guilford.

    E-mail Citation »

    Puts child abuse and neglect in the broader context of early attachment and the importance of early child and caregiver relationships. Provides underlying rationale and principles for specific effective interventions and how programs fit within health, social service, and early education systems. Good resource for graduate education.

  • Centers for Disease Control and Prevention. Global Violence Prevention.

    E-mail Citation »

    Well-designed, user-friendly extensive resource for all types of violence prevention information. Links allow the user to download many reports and articles, including World Health Organization reports.

  • Centre for Public Health, Liverpool John Moores University. Violence Prevention Evidence Base and Resources.

    E-mail Citation »

    Online database provides access to abstracts from published studies that measure effectiveness of interventions to prevent violence. The studies meet selection criteria and standards, with those highly rated identified by stars. Each abstract is coded by region, country, and type of violence (e.g., child, youth, intimate partner).

  • Chalk, Rosemary, and Patricia King, eds. 1998. Violence in families: Assessing prevention and treatment programs. Washington, DC: National Academy Press.

    E-mail Citation »

    Synthesis of research evidence to support recommendation for family violence interventions. Focuses on a critical review of 114 evaluation studies conducted between 1980 and 1996. Many tables will help readers categorize and make sense of a plethora of published studies.

  • Haskins, Ron, Fred Wulczyn, and Mary Bruce Webb, eds. 2007. Child protection: Using research to improve policy and practice. Washington, DC: Brookings Institution.

    E-mail Citation »

    Reports findings from the National Survey of Child and Adolescent Well-Being, a longitudinal study of children referred to child protective services. Provides information to challenge unfounded assumptions and makes recommendations to improve the practice of child protection.

  • Jordan, Brigid, and Robyn Sketchley. 2009. A stitch in time saves nine: Preventing and responding to the abuse and neglect of infants. Child Abuse Prevention 30:1–26.

    E-mail Citation »

    This excellent article summarizes the application of the public health approach and identifies primary, secondary, and tertiary interventions for child maltreatment. The section on out-of-home care addresses the dilemmas of the infant’s need for a secure attachment while working toward reunification with the parents. Other practice issues are identified, including infant mental health services.

  • Landy, Sarah, and Rosanne Menna, eds. 2006. Early intervention with multi-risk families: An integrative approach. Baltimore: Brookes.

    E-mail Citation »

    A comprehensive resource for scholars and practitioners interested in promoting the development of children living in families with multiple stressors. Challenges clinicians to avoid relying on favored approaches. Would be good for training clinicians and as a reference for practicing clinicians.

  • World Health Organization. World report on violence and health Geneva, Switzerland: World Health Organization, 2002.

    E-mail Citation »

    Provides a comprehensive global review of all types of violence. Clearly articulates the public health approach to prevention as it relates to violence. Resources include multiple links to general and specific types of violence-related websites.

LAST MODIFIED: 02/23/2011

DOI: 10.1093/OBO/9780199756797-0038

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