MCH Call to Action: Child Abuse

Child abuse and maltreatment is a silent and hidden morbidity and mortality issue today. A new report has shed light on this taboo subject, the dramatic statistics we have compared to other countries and the difference domestically between states.

Currently, the child maltreatment death rate is 11 times higher than Italy’s and 3 times higher than Canada’s. In the past 10 years, more than 20,000 children have died because of household abuse. Texas has a child abuse death rate of 4.05/100,000, 4 times higher than New Hampshire and Vermont.

So why these rates, why these disparities?

Many believe the answer is in our child protection service (CPS) workforce. Employees are overworked and the system is slow and ineffective. But as the investigation explains, these critics forget the fact that these services were made to protect children after abuse, not prevent them from being harmed in the first place.

Prevention: the key public health value. Child abuse must be seen as an issue in which the public health field can intervene, even more specifically with a Maternal and Child Health focus. What can MCH leaders focus on to help this phenomenon from continuing to escalate? What are areas with low child maltreatment rates doing that work?

1. The United States has a weak public system— our home visiting programs could be expanded, and until the Affordable Care Act goes fully into effect, we have no universal health care. Texas has low taxes, and high numbers of keeping families together. Compared to other countries, the U.S. has low taxes. Children are more likely to be uninsured, incarcerated, to not finish high school, and to die from abuse if public service programs do not have funding.
2. Child abuse has been found to be interlinked with these factors affecting families, including poverty and teenage pregnancy. When families do not have resources, education, training, or an understanding, children are at greater risk. High stress is also associated with these factors.
3. Education and training of adults who work with children. Diagnosis is difficult when injuries are internal, thus it is important for workers to understand the risks of abuse. This includes pediatricians, social workers, teachers, and counselors.
4. Cutting budgets has been the major focus of 2011, and more states are reducing prevention effort funding. Legislatures are not educated on the consequences of abuse, including the future costs to states in working down-stream. If you work with families early on, it is possible to reduce child abuse and neglect, affecting the life course. States with low child abuse rates invest in working up-stream.

We cannot lobby legislatures to increase funding if we do not have the general public behind us. As MCH leaders, we must work to reverse child abuse as a taboo and silent topic. Media campaigns, outreach, and education must be expanded. In the 20^th century, breast cancer was unmentionable, and now there is a month dedicated to battling it. Spread the word-here is the link to the BBC report: http://www.bbc.co.uk/news/world-us-canada-15288865.

Ad Council takes on Unintended Pregnancies

Today CNN covered an opinion piece from Laura Sessions Stepp, a Pulitzer Prize journalist and former Washington Post reporter, on young adults and contraception. The Ad Council has accepted a proposal from The National Campaign to Prevent Teen and Unplanned Pregnancy to run a series of ads targeting adults in their 20’s to use birth control. The campaign, called Bedsider.org, was created as a support network for women and includes PSA’s, a YouTube channel, and website. The website shows the less serious side to sex, while at the same time answering questions about contraception and the best method for the user. Videos use humor to promote annual doctor visits, birth control effectiveness, and set the record straight on recent news reports. Below is an example of a question and answer on IUD’s:

A study by the Guttmacher Institute surveying 1,800 unmarried men and women between the ages of 18-29 found that only 50% use birth control carefully and consistently. Using a weighted representative sample through telephone interviews (both landline and cell phone), the researchers also found that 31% of the women surveyed say they have had an unintended pregnancy. You can find more information about the study’s method and results here: http://www.thenationalcampaign.org/fogzone/PDF/FogZone.pdf.

With results like these, using mass communication and social media to promote birth control use may help 20-somethings feel more comfortable about talking to their doctor and accessing care.

National Radon Action Month

Ahem. The EPA has designed January as “National Radon Action Month”:

Pretty great, right? But for those readers reluctant to take advice from a Lego figure, here’s an overview:

What’s radon, anyway? Radon is a naturally occurring, radioactive gas that is released as uranium in the soil breaks down.  It is also the number one cause of lung cancer in non-smokers, and the number two cause (after tobacco) of death among smokers (see this factsheet from the World Health Organization for details).

Minnesota, like some other states in the upper midwest, has a high level of naturally occurring radon (the curious can find a county-by-county breakdown here).  Add to that our long winters indoors, with windows sealed tight–and you’ve got a serious public health problem.  According to a press release from the Minnesota Department of Health, one in three homes here has levels of radon that “pose a significant health risk” to their residents.

Wait — how does it get inside my home? Radon can enter a home through a number of pathways: cracks in foundations, spaces behind walls, through floor joints and crawlspaces.  Once inside, it can concentrate–particularly during the winter months, when ventilation may be less than adequate.

What can I do about it? First of all, have your residence tested. The MDH provides low-cost, short-term radon test kits here. If your home contains levels of radon above 4 pCi/L, the EPA recommends that you take action as soon as possible. By sealing up cracks or other radon routes and setting up a “radon reduction system” to mitigate the impact of any remaining gas, you’ll protect your health and the health of your loved ones.

For more facts on radon, check out a brochure from the Minnesota Department of Health, available here: http://www.radonleaders.org/sites/default/files/MDH%20Radon%20Brochure.pdf

Teen moms: the new celebreality?

Over the past few weeks, the stars of “Teen Mom,” an MTV (ahem) “reality” show, have been in the news quite a bit.  For those of you unfamiliar with the series, now in its second season, here’s a synopsis: MTV producers follow four pregnant teens through their difficult decision to raise a child — or give the baby up for adoption, in the case of one teen mom — while simultaneously attending school, working, and negotiating relationships with their parents and (frequently) the baby’s father. Averaging 3.3 million viewers per episode, even the show’s producer, Morgan J. Freeman, admits to surprise at the show’s popularity, noting that its audience appears drawn to the show’s main characters, Amber, Catelynn, Maci, and Farrah, rather than the subject matter.

Critics of the show — and there are many, spanning the political gamut — claim it glamorizes teen pregnancy. As part of the season 2 publicity rounds,  air-brushed photos of the shows’ teen moms have graced the covers of US Weekly, People, and Ok Magazine, with headlines like “Maci — back with Ryan!,” “Second Chance at Love,” and “We Miss our Baby.”

But before we roll our eyes and turn off TV (not bad advice, in any case), let’s consider the facts. Even a cursory glance at the “Teen Mom” message boards indicates that the show has teens talking about the risks of unprotected sex.  All four of the moms featured have dealt with some difficult issues as a result of their pregnancy: money problems, break-ups, fights with mom and dad. The Kaiser Family Foundation, in fact, has partnered with MTV to offer “Teen Mom” videos as part of their ongoing sex education campaign,“It’s Your Sex Life.”

The National Campaign to Prevent Teen and Unplanned Pregnancy, meanwhile, has just released the results of a report that explores the relationship between media and teen pregnancy discussions (full disclosure: the National Campaign works with MTV on these shows and produces discussion guides that go along with MTV’s 16 and Pregnant). Nearly 50 percent of teenagers surveyed (N=1,008) said they “discussed sex, love, or relationships with an adult because of something they saw in the media about teen pregnancy.”

This blogger wonders, however, how MTV’s audience will react to the show’s recent focus on intimate partner violence.  After months of verbal abuse, the relationship between one teen mom and the father of her child deteriorated into physical violence — which MTV filmed (and showed) in its entirety. Note to producers: a couple of PSAs just don’t cut it.

Super Bowl Sunday: A Failed Opportunity to Redirect our Focus on Family Planning

In a break from the typically light-hearted ads promoting cars, soda, and beer, this year’s Super Bowl was the first in history to feature an advertisement from an advocacy organization.  Created by Focus on the Family—an evangelical group opposed to abortion—the ad highlighted the story of Tim Tebow, a Heisman Trophy-winning quarterback for the Florida Gators whose mother chose to continue her pregnancy against medical advice.

CBS decided to air the ad despite drawing criticism from pro-choice groups and counter-protests from pro-life organizations.  Ultimately, the message was tamer than anticipated (a pro-life viewpoint was never explicitly stated).  That the commercial’s subtle execution was still anti-choice serves as a reminder that discussion about family planning issues in the U.S. remains highly political.  Instead of addressing the complexities of a woman’s right to choose (failing even to acknowledge that Pam Tebow was able to choose her preferred medical approach), the ad distills the message of family planning into an overly simplistic “celebration of family and life.”  Though the ad has spurred much discussion, it has done nothing to open meaningful dialogues about abortion.  Perhaps a 30-second advertisement is not an appropriate venue for responsible discussions about family planning.

To view the Tim Tebow Super Bowl ad: http://www.youtube.com/watch?v=PDwHywPk4kI

For Planned Parenthood’s response to the Tim Tebow ad, please visit: http://www.youtube.com/watch?v=utcxpuHF7jg