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A Discussion on Child Abuse Prevention with Prevent Child Abuse America: Q&A with Jennifer Jones
This year’s theme for National Child Abuse Prevention Month is, “Thriving Children and Families: Prevention with Purpose.” Children have the right to be safe, nurtured, and raised in a stable environment, and for this to happen, families need holistic support and resources to be provided equitable opportunities to thrive. By building upon the strengths of families, we can enable them to live safely and help prevent maltreatment before it becomes a possibility. Further, it is the responsibility of those working and leading in communities to partner with families as a means of support to prevent and mitigate risks of formal child welfare intervention – especially as it has been particularly harmful for children and families in communities of color. If child welfare can move from historical, reactive child protection systems to systems that are designed to proactively support child and family well-being, implications will lead to greater prevention of child maltreatment and fewer unnecessary family separations. ASCI’s conversation with Jennifer Jones, Chief Strategy Officer at Prevent Child Abuse America highlights the important prevention strategies and holistic approach child welfare can use to improve child and family well-being for families to thrive.
ASCI: We know child welfare has historically been punitive and reactive through policies and practices by CPS. How can child welfare move from traditional, reactive child protection systems to systems designed to proactively support the well-being of children and families, and prevent child maltreatment and unnecessary family separation?
Jennifer Jones: There have been calls by many advocates and others to reform, transform or dismantle our nation’s child welfare system. There is an urgency for creating a much different response to families in need of services and supports before child abuse and neglect occur. Many are calling for more focused attention and investments on primary and secondary prevention. To move towards a child and family well-being system in this country, we must prioritize race equity and co-creating with people with lived expertise. We also need a comprehensive prevention vision and system in this country—one that works in partnership with the current child protection system but sits outside of that system. While child welfare can arguably become more prevention focused, expanding the scope and role of child protection to include prevention should not be our priority. We should advance a comprehensive prevention system with an explicit focus on addressing poverty that will ultimately bring down caseloads within the child protection system.
We need a public health approach to prevention—working in partnership to advance the health and well-being of our population. It’s not one sector, or profession or discipline. It’s all of us together working to improve the conditions in which we all live. We also need to ensure that families have access to community-based services and supports whenever they need them. Far too often, the only way families who need help can get that help is by coming to the attention of the child welfare system. We need a system of care and support that responds to families’ needs at the right time.
ASCI: How is Prevent Child Abuse America working to do this strategically and intentionally?
JJ: Prevent Child Abuse America is the nation’s oldest and largest organizations committed to preventing child abuse and neglect before it happens. We promote policies, programs and resources informed by science that enable all kids, families, and communities to thrive – today, tomorrow and for generations to come.
We do this in several different ways. First, [ we do this] through our signature home visiting program, Healthy Families America. We are in 600 sites, and one of the most frequently implemented models under the federal Maternal, Infant and Early Childhood Home Visiting program.
We also have a statewide network of Prevent Child Abuse America chapters in 44 states, and Washington, DC. We partner closely with them to advance our collective missions and promote thriving children, families and communities.
We have a national policy team that advocates at the federal level for the Child Abuse Prevention and Treatment Act or CAPTA, MIECHV, and other key federal programs, like the Child Tax Credit that help support children and families.
And finally, to shift the conversation from child abuse and neglect to primary prevention, our communications team works closely with our state chapter network and HFA sites to articulate, elevate, and amplify our collective message and mission.
Our organization’s purpose is to move towards a more prevention focused system. I’d like to highlight two key things we are working on to support the transformation of our nation’s child welfare system.
First, is the Thriving Families, Safer Children movement. The inequities in our current system, and the disparities it produces are more visible now than ever before. We believe the time is now to drive the transformation towards a system that achieves the outcomes we have long desired for all children, families, and communities. The Thriving Families, Safer Children movement provides us an opportunity to accelerate that transformation.
The U.S. Children’s Bureau, Casey Family Programs, the Annie E. Casey Foundation, and Prevent Child Abuse America have joined together in a first of its kind partnership with parents, youth, and community organizations to work with and support 22 Thriving Families, Safer Children sites in creating a more just and equitable child and family well-being system that benefits all children and families and breaks the harmful intergenerational cycles of trauma and poverty. We are committed to directly addressing structural and social determinants of health, including systemic and structural racism.
We also have a new and exciting campaign that we have created in partnership with Social Current and FrameWorks Institute, called Building Better Childhoods.
In 2021, Prevent Child Abuse America joined forces with Social Current and FrameWorks to update our 2004 prevention framing brief. To make the case for the policies and strategies we need to ensure that every child grows up in a safe, stable, nurturing environment, our framing needs to widen the lens to include the factors that shape those environments. And to build a broader constituency for those approaches, the story we tell must spark a sense of collective responsibility and offer a sense of realistic hope.
FrameWorks recommends that childhood adversity be framed as a public issue, a preventable problem, and a solvable problem. This campaign will help us shift the narrative from the punitive, reactive approach we currently take to address family challenges and struggles to one that makes it a solvable problem where we all have a role to play.
ASCI: The poverty rate has increased 1.7% since the 2020 life-changing pandemic putting families at a greater risk of experiencing poverty. Are children and families living in poverty at a greater risk of being reported by child protection services for child abuse and neglect? If so, why?
JJ: There is consistent and substantial research that shows a relationship between poverty and neglect, including a causal relationship. Despite neglect being present in all socioeconomic classes, families with lower incomes have higher rates of neglect. Families below the poverty line are three times more likely to be substantiated for child abuse and children living in poverty are at highest risk for neglect. This can be due in part to families not having access to the financial resources they need to provide adequate care and material items to ensure their children thrive.
Additionally, there are numerous studies that show providing economic and concrete supports to families can reduce cases of neglect. Most kids are being removed for neglect – things like failure to meet basic needs such as adequate food, clothing, housing, or other basic care, and the inability to care for their children due to substance use or mental health issues. Researchers argue that the reason child neglect has not decreased in the U.S., like other forms of abuse, is due to our failure at the policy level to recognize and implement economic and concrete supports as a strategy to prevent child maltreatment.
Families lacking income and resources for basic needs are often referred to the child welfare system for neglect and this disproportionally impacts Black and Indigenous families. We need to support families sooner with economic and concrete supports and prevent entry into the child welfare system by addressing poverty.
ASCI: How has this historically impacted children and families of color?
JJ: Children and families of color are more likely to be impacted by poverty and to come to the attention of the child welfare system for neglect and other forms of child maltreatment. At the same time, families of color often reside in communities with high concentrations of poverty with limited access to services and supports.
Overall, 37% of children and young people in the U.S. experience an investigation for child maltreatment before their 18th birthday. For white kids it is 28%, and for Black kids, it is significantly higher at 53%. This is where the disparities within the child welfare system for Black and other families of color begin.
Every year, close to 220,000 children enter foster care. The greatest disparity is for Black children and youth, while they make up about 14% of the overall population under 18, they account for 24% of removals. This means they are about 63% more likely to enter foster care than their white peers.
It’s even more significant for American Indian/Alaskan Native – they suffer from the greatest disproportionality of any race. They make up less than one percent of the population yet 2.4% of removals. This equates to them being 207% more likely to enter care than their white peers.
In addition, while 14% of U.S. children are Black, they make up 27% of children living below the poverty line.
I also want to add that while these past few years have been extremely challenging for all of us, communities of color have been hit much harder by COVID and job loss than the white population. We also know that adverse childhood experiences are more common among people of color, and this when compounded with the constant experience of subtle and explicit discrimination, create an even greater risk for chronic disease. And, we know that people with chronic disease and autoimmune disorders are at a much greater risk for being severely impacted by COVID. So, if we are going to reduce inequities in health outcomes, we must focus on preventing and mitigating adverse childhood experiences and addressing the daily contexts in which people live, including poverty and racism.
If we are going to reduce inequities in health outcomes, we must focus on preventing and mitigating adverse childhood experiences and addressing the daily contexts in which people live, including poverty and racism.
Jennifer Jones
ASCI: What prevention strategies can child welfare agencies use to help children and families at risk of the adverse effects of living in lower-income environments/communities with limited resources?
JJ: First, our country needs to invest more in prevention. Currently, there is about $33 billion in public expenditures by state and local child welfare agencies and only about 15% of that is spent on prevention.
We need to support and invest in community-based resources and supports, like family resource centers, home visiting services, and community action agencies. We need to make sure that all families have access to the services and supports they need regardless of where they live, which means we need to invest heavily in under-resourced communities.
When we talk about improving the conditions in which people live, it means addressing adverse community environments – like lack of affordable and safe housing, community violence, systemic discrimination, and limited access to social and economic mobility. These conditions compound one another, and further add to the stress of individual ACEs. It’s essential and imperative to not only address individual ACEs, but also the conditions in which people live.
There’s also a recent body of research that I’ve been involved in called Positive Childhood Experiences (PCEs). I had the pleasure of working with Dr. Christy Bethell and her team at Johns Hopkins School of Public Health to create the positive childhood experiences score. We looked at things like, ‘Did your family stand by you during difficult times?’ ‘Did you feel a sense of belonging in high school?’ ‘Did you have two non-parent adults that took a genuine interest in you?’
In our research, we discovered that nearly 60% of individuals with four or more ACEs and only 0-2 PCEs reported depression or poor mental health in comparison to only slightly over 20% with four or more ACEs and 6-7 PCEs. We saw a similar pattern for those with lower ACEs scores.
Thus, the more positive childhood experiences you have, even despite high ACE scores, the less likely you are to experience depression or poor mental health in adulthood. So, positive childhood experiences are just as impactful, if not moreso on adult outcomes. We need to spend as much time if not more, promoting positive childhood experiences and safe, stable, nurturing environments.
The CDC highlights six key strategies for preventing ACEs including things like, strengthen economic supports for families,
promote social norms that protect against violence, and adversity, invest in early childhood programs like home visiting, teach skills like social-emotional learning, connect youth to caring adults and activities, and lessen harm and prevent future risk by using treatment services and supports for ACEs, substance use and mental health.
These are all concrete ways we can work to prevent childhood adversity, promote the positive, strengthen early childhood, and improve the environments in which children and families live.
If we focus more investment on upstream approaches, like these, according to the CDC, we will see significant reductions in negative health outcomes, including a 44% reduction in depressive disorder, a 24% reduction in asthma, a 13% reduction in coronary heart disease, a 6% reduction in cancer and, a 5% reduction in unemployment.
Investing in prevention not only keeps children safe and thriving in their own families and communities, it also creates significant savings in our deep ends systems, like health care, child welfare, and corrections.