Child abuse deaths are preventable

Child abuse and neglect are major public health crises — they can devastate a person, a family, a community, and society as a whole. We’ve seen this in our own city. The recent, devastating murder of an 8-year-old girl in Uptown, allegedly by her mother, shows the effects of child abuse and neglect impact Chicagoans every day.

The Children’s Bureau of the U.S. Department of Health and Human Services estimates that in 2020, 618,000 children were victims of child maltreatment and 1,750 children died from abuse and neglect. And the 2019 Community Assessment issued by Chicago’s Department of Family & Support Services shows the city averaged nearly six substantiated cases of abuse or neglect per 1,000 children ages 0 to 5 — and the actual numbers are almost always higher than reported.

It’s clear from recent research that child abuse and neglect fatalities are preventable, and the Commission to Eliminate Child Abuse and Neglect Fatalities (CECANF) highlighted the importance of a multi-disciplinary approach, shared accountability, and leadership to accomplish this.

A responsibility to protect against harm

Years of research have shown that adverse childhood experiences (ACEs) — events or circumstances that may be traumatic to children during the first 18 years of life, such as domestic violence or homelessness — can have short- and long-term physical, psychological, and behavioral consequences. With a public health approach, most prevention strategies focus on the behavior and circumstances of children and families.

Unfortunately, the government’s responsibility to protect against social harms — especially in the prevention of child abuse and neglect — is often overlooked and undervalued.

A robust body of literature supports the notion that “family poverty and inequality are key drivers of harm to children.” There is clear evidence of a strong association between family poverty and the risk of child abuse — and studies suggest there is an increase in risk during periods of economic uncertainty, like the Great Recession of 2007 and, most recently, the COVID-19 pandemic. Communities nationwide have experienced immense strife and stress, and the greater the economic hardship, the greater the likelihood and severity of child abuse.

As experts with decades of experience, we have seen first-hand the gaps in resources for children and families — gaps that can lead to harm. And as parents ourselves, we know that parenting is challenging even in the best of times.

It’s important to note that neither poverty or any other single factor will lead to child abuse. Some children from affluent families will experience abuse, and most children living in poverty will not. But abuse and neglect are much less likely to occur when we eliminate the stressors that overwhelm parents, such as lack of affordable child care, food insecurity, or community violence. When we focus collectively on building safe, stable, and nurturing environments that children need to learn and flourish, we allow parents time and space to concentrate on providing their children with nurturing experiences.

Child maltreatment is complex, but family stress is at its core. Some families “sink” when dealing with stress, while others “swim.” The resources and strengths of a family will shape the outcome after the stressful event.

Now is the time to reframe the association between poverty and child abuse as a public responsibility. It is a solvable, preventable problem, not a further source of shame and pressure on disadvantaged families who have faced repeated social inequities.

If we want a healthier and more prosperous population, we must sow the seeds now. Studies in the U.S. show that raising the income of families in poverty has a statistically significant impact on reducing rates of child abuse and neglect. Breaking the cycle of abuse and neglect requires financial investment, and the return on this investment takes time.

One proven model for supporting families is home visitation, which connects parents with resources and tools to support positive parenting practices, physical and mental wellness, and their own education and career goals. We should increase federal funding for these programs through initiatives such as the Maternal, Infant, and Early Childhood Home Visiting Program.

In addition, there’s the expanded child tax credit, which lifted 3 million children out of poverty in 2021 and should be reinstated permanently. Our nation also needs family-friendly policies like universal paid family leave and affordable child care.

The nation’s children deserve a brighter, more just future. We owe it to them, and their families, to help prevent abuse and neglect. We must sow the seeds for every child to grow, flourish, and reach their full health and life potential.

Dr. Melissa Merrick is President and CEO of Prevent Child Abuse America, which has its national headquarters in Chicago.

Dr. Norell Rosado currently serves as the Interim Division Head of Child Abuse Pediatrics at Lurie Children’s Hospital of Chicago and is also an associate professor of pediatrics at Northwestern University Feinberg School of Medicine.

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