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Public Health Leadership Initiative

Millions of children are abused or neglected every year. Research indicates those experiences have an impact lasting long after childhood and may contribute to some of the nation’s worst health problems.

The Public Health Leadership (PHL) Initiative believes public health agencies can make great strides in preventing child maltreatment. The purpose of the Public Health Leadership Initiative is to assist and support state agencies as they work to better the lives of children and adults.

Learn More about the PHL Initiative

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Understanding Child Maltreatment

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Recent Research

  • The Cost of Child Abuse and Neglect
    The financial costs for victims and society are substantial. A recent CDC study, The Economic Burden of Child Maltreatment in the United States and Implications for Prevention,found the total lifetime estimated financial costs associated with just one year of confirmed cases of child maltreatment (physical abuse, sexual abuse, psychological abuse and neglect) is approximately $124 billion.

    Published in Child Abuse and Neglect, The International Journal, the study looked at confirmed child maltreatment cases—1,740 fatal and 579,000 non-fatal—for a 12-month period. Findings show each death due to child maltreatment had a lifetime cost of about $1.3 million, almost all of it in money that the child would have earned over a lifetime if he or she had lived. The lifetime cost for each victim of child maltreatment who lived was $210,012, which is comparable to other costly health conditions such as stroke with a lifetime cost per person estimated at $159,846 or type 2 diabetes, which is estimated between $181,000 and $253,000.

  • The Foundations of Lifelong Health Are Built in Early Childhood
    A vital and productive society with a prosperous and sustainable future is built on a foundation of healthy child development. Health in the earliest years—beginning with the future mother’s well-being before she becomes pregnant—lays the groundwork for a lifetime of vitality. When developing biological systems are strengthened by positive early experiences, children are more likely to thrive and grow up to be healthy adults. Sound health also provides a foundation for the construction of sturdy brain architecture and the achievement of a broad range of skills and learning capacities.

    The Foundations of Lifelong Health Are Built in Early Childhood, a report co-authored by the National Scientific Council on the Developing Child and the National Forum on Early Childhood Policy and Programs, presents a framework for understanding how policies and communities affect the biological underpinnings of lifelong health. The report was funded, in part, by CDC, and now a new 7-minute video explains the framework and its relevance to policy decisions.

  • Neuroscience, Molecular Biology, and the Childhood Roots of Health Disparities: Building a Framework for Health Promotion and Disease Prevention
    In a CDC-funded paper, Neuroscience, Molecular Biology, and the Childhood Roots of Health Disparities: Building a New Framework for Health Promotion and Disease Prevention, authors Jack P. Shonkoff, M.D, W. Thomas Boyce, M.D., and Bruce S. McEwen, Ph.D., discuss how the origins of many adult diseases can be traced to negative experiences early in life. The authors suggest confronting the causes of adversity before and shortly after birth may be a promising way to improve adult health and reduce premature deaths.

  • Safe, Stable, and Nurturing Relationships May Shield Children Against Poor Health Later in Life
    Early childhood exposure to adversities such as child abuse or neglect are associated with increased risk of lifetime physical and mental health consequences. A recent CDC commentary in the Journal of the American Medical Association suggests that progress in preventing the nation's worst health problems – such as obesity, diabetes, and heart disease – can be made by investing in programs that promote raising infants and young children in healthy, safe, stable, and nurturing surroundings.

    In Creating a Healthier Future Through Early Interventions for Children, the authors suggest investments in programs that are effective in promoting these important aspects of children’s surroundings can reduce exposure to adverse events, counter adverse experiences in childhood when they do occur, and promote optimal development.

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Additional Resources

  • Adverse Childhood Experiences (ACE) Study
    The Adverse Childhood Experiences (ACE) Study is one of the largest investigations ever conducted on the links between childhood maltreatment and later-life health and well-being.
  • CDC’s Strategic Direction for Child Maltreatment
    Our key strategy in preventing child maltreatment is the promotion of safe, stable, and nurturing relationships between children and caregivers.
  • Child Maltreatment Uniform Definitions
    The purpose of the child maltreatment uniform definitions and recommended data elements is to present a definition of child maltreatment, its associated terms, and recommended data elements for voluntary use by individuals and organizations in the public health community.
  • Child Welfare Information Gateway
    The Child Welfare Information Gateway connects child welfare and related professionals to comprehensive information and resources to help protect children and strengthen families. The gateway features the latest on topics from prevention to permanency, including child abuse and neglect, foster care, and adoption.
  • Doris Duke Charitable Foundation
    The PHL Initiative is supported in part by the Doris Duke Charitable Foundation. Their mission is to improve the quality of people’s lives through grants supporting the performing arts, environmental conservation, medical research and the prevention of child maltreatment, and through preservation of the cultural and environmental legacy of Doris Duke’s properties.
  • Nurse-Family Partnership
    Nurse-Family Partnership® (NFP) helps change the lives of vulnerable first-time moms and their babies through ongoing home visits from registered nurses. This evidence-based community health program has proven results including long-term family improvements in health, education and economic self-sufficiency.
  • Pediatric Abusive Head Trauma—Definitions
    This publication was developed to improve the quality and consistency of data on abusive head trauma in children. It provides a definition of abusive head trauma and presents recommended data elements for use by individuals and organizations.
  • Triple P Study
    The U.S. Triple P System Trial, funded by the Centers for Disease Control and Prevention (CDC), found lower rates of substantiated abuse cases, child out-of-home placements, and reductions in hospitalizations and emergency room visits for child injuries in nine study counties in South Carolina where parenting interventions were implemented.
  • Triple P-Positive Parenting Program®
    The Triple P-Positive Parenting Program® is a multi-level, parenting and family support strategy. Triple P aims to prevent behavioral, emotional and developmental problems in children by enhancing the knowledge, skills and confidence of parents (from the Triple-P website)

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