Child Abuse Prevention Blue Ribbon Campaign National Exchange Club April 29, 2009 David L. Corwin, MD Professor and C

1. Child Abuse PreventionBlue Ribbon Campaign National Exchange ClubApril 29, 2009David L. Corwin, MDProfessor and Chief Child Protection and Family Health DivisionPediatrics Department University of Utah School of Medicine

2. Invest in the Future:PreventionBuilds Success Give brief history of presentation. Give brief history of presentation.

3. So many people say that in Utah we put children first. As much as we may talk about this we do not allocate the necessary resources to make it true. This slide will be updated when PCAA concludes a study that is being underwritten by the Doris Duke Foundation. From what we understand the picture is not much better. If you are asked for details on why Utah is so high, point out that Utah includes witnessing domestic violence in its definition of child abuse, and that most states do not. So many people say that in Utah we put children first. As much as we may talk about this we do not allocate the necessary resources to make it true. This slide will be updated when PCAA concludes a study that is being underwritten by the Doris Duke Foundation. From what we understand the picture is not much better. If you are asked for details on why Utah is so high, point out that Utah includes witnessing domestic violence in its definition of child abuse, and that most states do not.

4. Look at this�think of the good that could be done with this money. We could be doing so much good to and for society. 104 billion dollars lost is a sad commentary. Prevention is key!Look at this�think of the good that could be done with this money. We could be doing so much good to and for society. 104 billion dollars lost is a sad commentary. Prevention is key!

5. This is the cost in Utah- just think of the great things we could do to improve the lives of families.This is the cost in Utah- just think of the great things we could do to improve the lives of families.

6. This slide is a normal healthy child�s brain and next to it the brain of a child who was sensory deprived because of living in an orphanage. There is a dramatic different. Children must be nurtured and loved in order to develop needed synapses and connections.This slide is a normal healthy child�s brain and next to it the brain of a child who was sensory deprived because of living in an orphanage. There is a dramatic different. Children must be nurtured and loved in order to develop needed synapses and connections.

7. Cycle of Safety and Success We can see what babies are born to do. It happens very normally and naturally in healthy productive environments. Our society as a whole will benefit in many ways. The economic benefits of taking care of our babies are long lasting.We can see what babies are born to do. It happens very normally and naturally in healthy productive environments. Our society as a whole will benefit in many ways. The economic benefits of taking care of our babies are long lasting.

8. Healthy Brain DevelopmentResults From: Nurturing, stable and consistent relationships with supportive and responsive adults Sense of safety and security Absence of stress (no family violence or substance abuse) Positive stimulation (visual, auditory, emotional) This is what every child deserves. This is the minimum of baby deserves. This is what every child deserves. This is the minimum of baby deserves.

9. Cycle of Violence and Abuse When children do not have a nurturing, loving environment the effects are very different. The economic impact is astounding. The cost is not only horrible for the child and family but impacts our nation as a whole. As a nation we cannot afford to have these costs continue to rise.When children do not have a nurturing, loving environment the effects are very different. The economic impact is astounding. The cost is not only horrible for the child and family but impacts our nation as a whole. As a nation we cannot afford to have these costs continue to rise.

10. Negative Impacts to Brain Development Exposure to domestic abuse or substance abuse may prevent a child from being able to maintain healthy emotional relationships. The result is often impulsive behavior and aggression and the inability to empathize with others. These impacts begin at birth and have long lasting effects. These children are often unable to creating loving relationships and struggle throughout their adulthood.These impacts begin at birth and have long lasting effects. These children are often unable to creating loving relationships and struggle throughout their adulthood.

11. The greatest capacity for brain development is from birth to three years of age. As this graph saddly shows us, this is when the least amount of money and resources are spent. This does not make sense and does not improve our future outlook.The greatest capacity for brain development is from birth to three years of age. As this graph saddly shows us, this is when the least amount of money and resources are spent. This does not make sense and does not improve our future outlook.

12. This is an impressive study that helps us understand the effects of adverse childhood experiences.This is an impressive study that helps us understand the effects of adverse childhood experiences.

13. These experience lead to many of our nation�s medical and social problems. Childhood abuse and neglect and domestic violence are two of these.These experience lead to many of our nation�s medical and social problems. Childhood abuse and neglect and domestic violence are two of these.

14. Here is a list of other adverse childhood experiences.Here is a list of other adverse childhood experiences.

15. Many chronic diseasesin adults are associated with adverse experiences in childhood. Many of these adverse experiences lead to chronic disease.Many of these adverse experiences lead to chronic disease.

16. This pyramid helps us understand what happened from birth to death. It is a continuum that can lead to illness and early death.This pyramid helps us understand what happened from birth to death. It is a continuum that can lead to illness and early death.

17. Smoking, severe obesity, physical inactivity, depression, suicide attempt, alcoholism, illicit drug use, injected drug use, 50+ sexual partners, STDs If someone has had adverse childhood experiences, they are much more likely to develop or face these issues. Change �of death� to �for life-threatening diseases� If someone has had adverse childhood experiences, they are much more likely to develop or face these issues. Change �of death� to �for life-threatening diseases�

18. The majority of adultswho experiencedlittle adversity in childhood have few, if any,health risk factors. These health risk factors are not near as pervasive in adults who faced little or normal childhood adversity.These health risk factors are not near as pervasive in adults who faced little or normal childhood adversity.

19. However, the majority of adults with an ACE Score of four or more,have multiple health riskfactors. The more adverse experiences the more likely it is that someone will have multiple health risk factors. The more adverse experiences the more likely it is that someone will have multiple health risk factors.

20. Adverse childhood experiences are related to health risk behaviors, morbidity, disability, mortality, and healthcare costs. I think this slide is redundant???I think this slide is redundant???

21. What is Working?

22. We know that early home child education and support is what is working.We know that early home child education and support is what is working.

23. Healthy Families Arizona We look at Arizona because their population make-up is close to that of Utah�s. They are also a politically conservative population.We look at Arizona because their population make-up is close to that of Utah�s. They are also a politically conservative population.

24. Healthy Families Arizona Outcomes 99.24% of families had no confirmed child abuse or neglect in 2006 Children are safer � 99% travel in car seats � 93% of parents lock up household poisons � 88% have smoke alarms 84% of children were immunized(Az rate for 2 year olds was 79%) I worry about these statements. Should we at least qualify them by saying �In Arizona� . . . Maybe have the first bullet say, �Reduces child abuse and neglect� and then put the AZ data in parents. I worry about these statements. Should we at least qualify them by saying �In Arizona� . . . Maybe have the first bullet say, �Reduces child abuse and neglect� and then put the AZ data in parents.

25. Healthy Families Arizona Outcomes Mothers� stress significantly reduced � Increased sense of competence as a parent � Increased parental attachment to infant � Reduced levels of depression � Social isolation overcome Mothers� life course improved � After 1 year: 40% employed 11.6% enrolled in school 95% of families rated services excellent

26. Changed 28th week part. NFP starts between the 17th week and the 28th week. Changed 28th week part. NFP starts between the 17th week and the 28th week.

27. Add new first bullet: Reduced child abuse and neglect.Add new first bullet: Reduced child abuse and neglect.

30. We are lucky to have FSC- they are great at preventing abuse and providing respite and referral.We are lucky to have FSC- they are great at preventing abuse and providing respite and referral.

32. This is a successful program that links parents to educators and resources.This is a successful program that links parents to educators and resources.

34. Children Experiencing High-Quality Early Care and Education Are: LESS likely to: Become teen parents Engage in criminal behavior as teens and adults/become incarcerated Abuse drugs Be dependent on welfare MORE likely to: Have good physical, emotional and mental health Have better jobs and higher earnings as adults Own their own homes Contribute to tax base When children are part of these programs- these are the outcomes.When children are part of these programs- these are the outcomes.

35. What Does Prevention Mean to Us? Put list in talking points: We take a stand and spend the money and resources necessary for children to be safe and to succeed. promoting strong healthy families helping parents succeed promoting child�s right to safety, health, nurturance and love. Put list in talking points: We take a stand and spend the money and resources necessary for children to be safe and to succeed. promoting strong healthy families helping parents succeed promoting child�s right to safety, health, nurturance and love.

36. What Challenges Do We Face? Financial challenges are the greatest. We have to put money in prevention without taking money from existing services and intervention programs. We must put money in prevention with the understanding that we will not see an immediate return on our investment. But it will happen. In the future it will happen. Figures? I have noted $800 million�where is that from? Utah spends only $2,500,000 in child abuse prevention. Most of this money is in federal flow through grants. Only state funding is in state match to federal funds, the Children�s Trust ($400,000) and the Crisis Respite Nurseries (approx $1.5 million) Financial challenges are the greatest. We have to put money in prevention without taking money from existing services and intervention programs. We must put money in prevention with the understanding that we will not see an immediate return on our investment. But it will happen. In the future it will happen. Figures? I have noted $800 million�where is that from? Utah spends only $2,500,000 in child abuse prevention. Most of this money is in federal flow through grants. Only state funding is in state match to federal funds, the Children�s Trust ($400,000) and the Crisis Respite Nurseries (approx $1.5 million)

37. How Can We HelpEach Other? All agencies must work together- knowing that each of us is just part of the puzzle.All agencies must work together- knowing that each of us is just part of the puzzle.

38. What Are OurNext Steps? Present this to as many people as possible. To reach decision makers. To make a change like unto the change made in smoking laws. Grass-roots campaign. Who would have thought that 20 years ago there would be no smoking � keeping children safe. We must invest in children and families.Present this to as many people as possible. To reach decision makers. To make a change like unto the change made in smoking laws. Grass-roots campaign. Who would have thought that 20 years ago there would be no smoking � keeping children safe. We must invest in children and families.

40. Utah Child Abuse Prevention Task Force Recommendations: Most promising approaches for improving child abuse prevention in Utah Improved integration and coordination of prevention programs Attention to cultural issues and competence Improve Utah�s Children�s Trust Fund to better assist child abuse prevention in Utah

41. The Utah Child Abuse Prevention Task Force Recommendations January 6, 2005

42. Vision We envision that throughout Utah: All children are protected from preventable harmful experiences that result from child abuse or neglect. All parents, especially new parents, are informed on how to provide safe and healthy formative years for their children. All communities are responding with early supportive services for successful parenting and healthy childhood development. Increased means are available to provide healthy environments for children from resources once spent on the results of child abuse and neglect. For all children, it is great to be a child!

43. The Utah Healthy Families-Safe Kids Action Plan Principles Preventing child abuse strengthens families All families want to raise safe, healthy, successful children. Helping parents succeed prevents child abuse. Prevention must be universal and voluntary. Prevention efforts must be effective and adapted to diverse cultural needs of Utah.

44. The Utah Healthy Families-Safe Kids Action Plan  Principles Prevention efforts must be collaborative; all community agencies and partners must be involved in planning and implementation. Prevention efforts must be public/private partnerships.

45. The Utah Healthy Families-Safe Kids Action Plan Findings Child abuse is a major public health problem. 7,829 case/ 10,932 child/adolescent victims in 2003 33.8 % increase in cases from 2000 to 2003 In 2002, 14.2 cases per 1,000 children (12.3 nationally)

46. The Utah Healthy Families-Safe Kids Action Plan Findings Child Abuse is a major public health problem. Acute injury Chronic illness Disability Death

47. The Utah Healthy Families-Safe Kids Action Plan Findings Child abuse is a major moral issue. Child abuse is wrong. Prevention is right. Children are precious, vulnerable and dependent on adults. They deserve our best. Our society is not safe until every child is safe. The safety and well being of children is everyones� moral responsibility.

48. The Utah Healthy Families-Safe Kids Action Plan Findings Child abuse is a major social issue. Violence and criminality Social dysfunction Relationship problems Addiction Lost productivity Pain and suffering Intergenerational cycle of abuse

49. The Utah Healthy Families-Safe Kids Action Plan Findings Child abuse is very expensive. We pay for its harms with our tax dollars, insurance premiums, lost productivity and reduced resources for other important services like education. $94 billion per year Preventing half of its child abuse cases could save Utah hundreds of millions of dollars that could help support education, health care and transportation

50. The Utah Healthy Families-Safe Kids Action Plan Findings Child abuse is preventable. Effective programs include: Early childhood home visiting Parent education, family resource centers, the Nurturing Program Parenting older children and adolescents, e.g. Strengthening Families

51. The Utah Healthy Families-Safe Kids Action Plan Findings Utah has many promising prevention programs Unfortunately, they have insufficient resources to reach enough families to significantly reduce child abuse in Utah. Utah needs enhanced coordination across funding streams and disciplines to reduce child abuse as much as possible.

52. The Utah Healthy Families-Safe Kids Action Plan Call To Action Citizens of Utah � support all Utah families in raising safe, healthy and successful children. Agencies, institutions and businesses of Utah are called upon to develop, implement and sustain flexible approaches for helping parents and families succeed. Proven models Flexible to accommodate cultural, geographic and socio-economic diversity of Utah

53. The Utah Healthy Families-Safe Kids Action Plan Call To Action The Utah Legislature and Governor Huntsman are called upon to facilitate increased funding of child abuse prevention from public, foundation, corporate and private sources by restructuring the Utah Children�s Trust Fund to maximize it flexibility and productivity.

54. The Utah Healthy Families-Safe Kids Action Plan Call To Action Professionals and institutions that work with children and families including schools, are called upon to increase public and policy makers� awareness of the harms and costs of child abuse as well as the benefits of preventing abuse.

55. The Utah Healthy Families-Safe Kids Action Plan Call To Action You are called upon to promote safe and healthy families, institutions and communities for all people of Utah. Inform yourself about child abuse and its prevention. Invite speakers from the Child Abuse Prevention Speakers Bureau to talk with your church, civic or neighborhood organization. Get to know and support the parents and families in your neighborhood. Support community programs and other efforts to help parents and families succeed.

56. We are all called upon to make a better, brighter future for all children in Utah! Our Children � Utah�s Future

60. The End� and hopefully a new beginning Thanks for listening Be part of the solution!