Child Abuse: A Public Health Concern

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Child AbuseA Public Health Concern

• Peggy Scheuermann, M.Ed., C.P.M.
• Deputy Division Director
• Prevention Interventions
• Childrens Medical Services
• Florida Department of Health

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Child Abuse

• Child Abuse (Defined in Chapter 39.01)
• Any willful act or threatened act that results
  in any physical, mental, or sexual injury or harm
  that causes or is likely to cause the childs
  physical, mental, or emotional health to be
  significantly impaired.

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The ACE Study(Adverse Childhood Experiences)

• Adverse Childhood Experiences and their
  relationship to Adult Health and Well-Being
• A collaboration between the CDC Kaiser
  Permanentes Health Appraisal Clinic in San Diego

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ACE Study - continued

• Examined the health, social and economic
  effects of adverse childhood experiences across
  the lifespan
• 18,000 participants

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ACE Study - continued

• What is an adverse childhood experience?
• Child abuse and neglect
• Growing up with domestic violence, substance
  abuse or mental illness in the home, parental
  loss, or crime

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ACE Study - continued
Many chronic diseases in adults are determined
decades earlier, in childhood. ACE determined
the likelihood of the 10 most common causes of
death in the US
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Long Term Health Effects of Child Abuse

• Top Ten Risk Factors
• Smoking
• Severe Obesity
• Physical Inactivity
• Depression
• Suicide Attempt
• Alcoholism
• Illicit Drug Use
• Injected Drug Use
• 50 Sexual Partners
• History of Sexually Transmitted Disease

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ACE Pyramid

• Early Death
• Disease, Disability Social Problems
• Adoption of Health-risk Behaviors
• Social, Emotional Cognitive Impairment
• Disrupted Neurodevelopment
• Childhood Maltreatment/Trauma

Life Span
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Long Term Health Effects of Child Abuse

• 103 more likely to smoke.
• 43 more likely to become suicidal
• 103 more likely to become alcoholics
• 192 more likely to develop a drug addiction

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Long Term Health Effects of Child Abuse

• More likely to be involved in teenage pregnancy
• More likely to be obese and have related health
  problems diabetes, heart disease.
• More likely to have mental health problems
• Have more doctor visits over the years.
• Use more health care resources

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Health Care Costs Related to Childhood Abuse

• Much of our health care costs can be attributed
  to the diagnosis and treatment of chronic
  diseases and conditions such as diabetes,
  obesity, cardiovascular disease, alcoholism and
  mental health issues

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Long Term Health Effects of Child Abuse

• Myth the younger the child who is the subject
  of or witness to violence the less the impact the
  event will have on the child.
• Reality clinical evidence suggests that young
  children do not forget what they have witnessed
  and that they have a extraordinary capacity to
  recall traumatic events.

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Child Abuse Prevention

• The Centers for Disease Control and Prevention
  recognizes child maltreatment as a serious public
  health problem with extensive short- and
  long-term health consequences.

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Child Abuse Prevention Continuum

• Primary
• Secondary
• Tertiary

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Primary Prevention

• A program or service directed at the
  population at large and designed to prevent child
  maltreatment before it occurs.

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Secondary Prevention

• A program or service directed at populations
  or persons identified as at risk and designed to
  prevent child maltreatment before it occurs.

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Tertiary Prevention

• A program or service provided to children and
  families after child abuse or neglect has
  occurred. The intervention is designed to
  prevent future incidents of abuse or neglect.

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Department of Health Child Abuse Prevention

• Floridas Five Year Plan for Child Abuse
  Prevention includes goals, objectives and
  strategies specific to Department of Health
  Programs.
• Strategies to prevent child maltreatment or
  the re-occurrence of child maltreatment.

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Department of Health Intervention

• Services provided to children and families
  after child abuse or neglect has occurred. The
  intervention is designed to prevent the incident
  of abuse from impacting the future health
  outcomes for the child.

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Challenge

• DOH Child Protection Team Program recently
  underwent dramatic process improvement efforts to
  increase services to abused children and improve
  process measures.
• Secretarys Performance Measures meeting we
  indicated the challenge we had to look for true
  health outcome measures for the children we
  serve.

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Challenge

• Look for ways to integrate programs across the
  Department to ensure that children identified as
  abused or neglected receive health services that
  will decrease the probability of negative long
  term health outcomes.

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Challenge

• Contact
• Mike Haney, Division Director
• 245-4217
• Peggy Scheuermann, Deputy Division Director
• 245-4220
• Bernice Gremer, Child Protection Unit Director
• 245-4246
• Janet Evans, Prevention Unit Director
• 245-4444 ext.2223

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• The world is a dangerous place to live not
  because of the people who are evil, but because
  of the people who dont do anything about it.
• -Albert Einstein