The	  Public	  Health	                     Frame	  and	  Approach	  to	  	        Learning     the	  Preven7on	  of	  	  C...
“Children’s health            is the extent to whichindividual children or groups of children are able orenabled to (a) de...
It is in the national interest to have healthy                       children.   Healthy children are …more likely to beco...
4
Adverse	  Childhood	  Experience	                 (ACE)	  Study	   q Maltreatment     §  Emotional, physical, and sexual...
Linked	  to	  Broad	  Array	  of	  Problems	     Depression                                                     Liver dise...
ACE Score and Alcoholism                             18                                                                   ...
Why it matters?                  8
Individual	  Health	  Influenced	  by:	   ž Biological             – individual attributes ž Environmental - family, comm...
On-­‐going	  Stressors	  Influence	  Individual	                       Health	  ž  Livingin poverty               Activate...
Physical               Cognitive     Health and              Functioning                            Development           ...
   Social	  ‘Determinants	  of	  Health	                      	  ž    Circumstances in which people are born,      grow u...
Social-­‐Ecological	  Model	                     Life Course   Individual   Family/Peer   Community   Social/Cultural     ...
Our Health Outcomesare Multi-Factorial                Educa7on	                                                           ...
Child	  abuse	  and	  neglect	  is	  result	  of	  complex	  transac7ons	  between	  mul7ple	  risk	  factors	  and	  ecol...
Reframing What We Do andHow We Do It.    De-scaling What Doesn’t    Work, Scaling Up What    Does Work           Measure O...
We are standing on the bank ofthe river, rescuing people whoare drowning. We have notgone to the head of the river tokeep ...
Risk	  Factors,	  Protec7ve	                        Factors	  and	  Resiliency	                                           ...
Risk Factors                                                        Protective FactorsGraphic	  Concept	  Adapted	  from	 ...
Safe, Stable, NurturingRelationships (SSNRs) Safety. Safety refers to the extent to which a child is free from fear and se...
The	  Public	  Health	  Approach	  to	                                 Ensure                                             ...
Data          ActionResearch          “Real World”Silos       SystemsTreatment        Ecological ModelRelationships       ...
Strengthening	  Families:	  	  Aligning	  Results	  for	  Families	                                                       ...
Do	  Something	  at	  Each	    Level	  of	  Preven7on	                                                                Infl...
LowestImpact (1)                                                                                             Equity	  	   ...
Child’s	  Health	  &	  Well-­‐being	  Depend	  on:	                                 A GOOD START                          ...
Contact Information           Sally Fogerty    Children’s Safety NetworkEducation Development Center, Inc.          43 Fou...
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Public health frame and approach to the prevention of child maltreatment

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Presentation by Sally Fogerty of Children's Safety Network (www.ChildrensSafetyNetwork.org) at Building Communities of Hope Event Oct. 23, 2012 in Springfield, Mass.

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Public health frame and approach to the prevention of child maltreatment

  1. 1. The  Public  Health   Frame  and  Approach  to     Learning the  Preven7on  of    Child  EDC transforms lives. Maltreatment   Sally  Fogerty   October  23,  2012  
  2. 2. “Children’s health is the extent to whichindividual children or groups of children are able orenabled to (a) develop and realize their potential,(b) satisfy their needs, and (c ) develop thecapacities that allow them to interact successfullywith their biological, physical, and socialenvironments.”From Children’s Health, the Nation’s Wealth, National AcademiesPress, 2004 2
  3. 3. It is in the national interest to have healthy children. Healthy children are …more likely to becomehealthy adults who will contribute as a productive citizenry and workforce to the continued vitality of society. National Academy of Sciences, 2004 Childrens Health, the Nations Wealth: Assessing and Improving Child Health
  4. 4. 4
  5. 5. Adverse  Childhood  Experience   (ACE)  Study   q Maltreatment §  Emotional, physical, and sexual abuse §  Emotional and physical neglect q Family Dysfunction §  Family Substance Abuse §  Family Mental Illness §  Intimate Partner Violence §  Parental Divorce/Separation §  Incarcerated Family Member –  Almost two-thirds had at least one ACE –  More than one in five had 3 or more ACEsAdverse Childhood Experiences (ACEs) fact sheet. www.cdc.gov/nccdphp/ace
  6. 6. Linked  to  Broad  Array  of  Problems   Depression Liver disease Suicide Heart disease Current smoking Unintended pregnancy Teenage pregnancy STDs Teenage paternity Memory deficits Work Absenteeism Illicit drug use IPV Perpetration Early alcohol use Slide courtesy of Valerie Edwards, PhD. Div. of Adult and Community Health. CDC
  7. 7. ACE Score and Alcoholism 18 ACE    SCORE   16 Percent With Health Problem 0 1 2 3 4 or more 14 12 10 (%) 8 6 4 2 0 Problem w/alcohol or Began drinking <=14 years consider self alcoholicSlide courtesy of Valerie Edwards, PhD. Div. of Adult and Community Health. CDC
  8. 8. Why it matters? 8
  9. 9. Individual  Health  Influenced  by:   ž Biological – individual attributes ž Environmental - family, community ž Social Influences – population experience 9
  10. 10. On-­‐going  Stressors  Influence  Individual   Health  ž  Livingin poverty Activatež  Financial strain Stressž  Lack of social Pathways support Blood pressure Heart rate Altered reflexes 10
  11. 11. Physical Cognitive Health and Functioning Development GeneticsEnvironment Emotional/ Social Behavioral Functioning Functioning 11
  12. 12.   Social  ‘Determinants  of  Health    ž  Circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness.ž  Circumstances shaped by: economics, social policies, and politics. Could someone help me with these? I’m late for math class CSMHA - NASBHC MHET 12
  13. 13. Social-­‐Ecological  Model   Life Course Individual Family/Peer Community Social/Cultural Environment
  14. 14. Our Health Outcomesare Multi-Factorial Educa7on   Health   Family/Peer   Neighborhood  Services   Child   Policy   Community   Family   Support   Social   Welfare   Graphic  Concept  Adapted  from  Neal  Halfon,  UCLA   14
  15. 15. Child  abuse  and  neglect  is  result  of  complex  transac7ons  between  mul7ple  risk  factors  and  ecologies.  It  is  …   Preventable Multifaceted Requiring Multilevel and Multidisciplinary solutions Collaborations & partnerships which are cross-agency, disciplines and community- based 15
  16. 16. Reframing What We Do andHow We Do It. De-scaling What Doesn’t Work, Scaling Up What Does Work Measure Outcomes not just Services 16
  17. 17. We are standing on the bank ofthe river, rescuing people whoare drowning. We have notgone to the head of the river tokeep them from falling in. Gloria Steinem, 2002 17
  18. 18. Risk  Factors,  Protec7ve   Factors  and  Resiliency    Risk factors: something shown to be associated with   ahigher incidence when populations exposed to factor.Protective factors: something present increases healthand well-being of children and families.Resilience: set of skills & behaviors which appear toprevent more serious effects due to trauma, illness andother life events 18
  19. 19. Risk Factors Protective FactorsGraphic  Concept  Adapted  from  Neal  Halfon,  UCLA   19
  20. 20. Safe, Stable, NurturingRelationships (SSNRs) Safety. Safety refers to the extent to which a child is free from fear and secure from physical or psychological harm within his or her social and physical environment. Stability. This refers to the degree of predictability and consistency in a childs environment. Families that are stable and have regular routines provide children with the consistency needed to lessen the impact of stressful experiences. Nurturing. Nurturing refers to the extent to which a parent or caregiver is available and able to sensitively respond to and meet the needs of their child 20
  21. 21. The  Public  Health  Approach  to   Ensure WidespreadPreven7on   Adoption Develop and Test Prevention Strategies Identify Risk and Protective Factors Define the Problem 21
  22. 22. Data ActionResearch “Real World”Silos SystemsTreatment Ecological ModelRelationships Results 22
  23. 23. Strengthening  Families:    Aligning  Results  for  Families   23
  24. 24. Do  Something  at  Each   Level  of  Preven7on   Influencing Changing Organizational Policy & Practices Legislation Fostering Coalitions & Networks Educating ProvidersPromoting Community Education Strengthening Individual Knowledge & Skills Prevention Institute 24
  25. 25. LowestImpact (1) Equity     Education & 1 Counseling Framework   2 Clinical Interventions 3 Long Lasting Protection Health Interventions Highest Changing the Context HealthyImpact (5) 4 Choices as Default Options Social and Environmental 5 Determinants of Health This pyramid is adapted from Thomas Frieden, MD, MPH, presented at the Weight of the Nation conference in Washington, DC, July 27, 2009
  26. 26. Child’s  Health  &  Well-­‐being  Depend  on:   A GOOD START GOOD FUTURE GOOD CARE GOOD SUPPORT 26
  27. 27. Contact Information Sally Fogerty Children’s Safety NetworkEducation Development Center, Inc. 43 Foundry Ave Waltham, MA 02453 www.ChildrensSafetyNetwork.org 1-617-618-2918 27

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