Child abuse and neglect must be treated as a public health issue

An estimated 1 in 4 children experience some form of child abuse or neglect in their lifetimes. This type of unimaginable trauma contributes to depression, problems at school, violence, diabetes, obesity, substance abuse, and suicide. To significantly reduce child abuse or neglect, we must begin treating them right away as serious public health problems by expanding public and private sector funding for research, training, and prevention.

Why the sense of urgency? In a new national public opinion survey commissioned by our organizations, Research!America and the National Foundation to End Child Abuse and Neglect (EndCAN), a substantial percentage of those surveyed said child abuse and neglect is a problem in their local communities, and they know someone who has experienced it.

More than half of African-Americans (54 percent) and Hispanics (51 percent), along with 43 percent of non-Hispanic whites and 34 percent of Asians, said they personally consider child abuse and neglect a “serious problem” in the United States — but don’t believe others have the same opinion. In fact, only 39 percent of African-Americans, 38 percent of Hispanics, 29 percent of Asians, and 27 percent of non-Hispanic whites think that others view it as a serious problem. The survey shows that public awareness — including the awareness that many of our neighbors believe that child abuse and neglect a serious issue — is lacking and must be the first step in tackling this public health crisis.

Who bears the responsibility for ending child abuse?

According to a majority of all racial and ethnic groups surveyed, child and family services, followed by state and federal governments and then law enforcement, bear most responsibility to end child abuse and neglect. Across populations, most people agree that state and federal governments should fund research to better understand child abuse and neglect, find ways to prevent it, and intervene when needed. Non-profit organizations, academia, and the private sector should also play a role, the survey respondents said.

EndCAN, where one of us (R.K.) serves as the board chair, has joined the fight to end child abuse and neglect, with support from elected officials and research and public health communities across the country. Its goal is to stimulate and lead a nationwide movement to support training, prevention, advocacy, and research on child abuse and neglect with the intent of changing the perception of this issue as not just a social and legal problem but also as a health, mental health, and public health problem that can be treated and prevented.

A strong majority of survey respondents identified several priorities for research: finding ways to prevent each form of child abuse and neglect, identifying causes of abusive behavior and treatments to stop it, and developing best treatments for victims of abuse and neglect. Compared to other health threats that harm children, such as cancer, heart disease, and diabetes, we are decades behind in funding research to understand the causes of and change the outcomes for abused and neglected children.

To achieve a culture change in how we identify, prevent, and treat child abuse and neglect, it is imperative that the public health community and everyone with a stake in this issue work together to advocate for more research and evidence-based strategies to ensure the well-being of children and their families.

It’s time to start a new national conversation about child abuse and neglect, break the silence around it, and take action to end it. Our communities are depending on it.

Richard Krugman, M.D., is the board chair of the National Foundation to End Child Abuse and Neglect, a pediatrician, and professor at the Kempe Center at the University of Colorado School of Medicine. Mary Woolley is the president and CEO of Research!America, the nation’s largest not-for-profit alliance working to make research to improve health a higher national priority.