Preventing child abuse and protecting children is a shared community responsibility. Each of us has a part to play.
In 2012, Pennsylvania investigated child abuse reports at a rate of 8.6 per 1,000 children compared to the national rate of 42.7 per 1,000 children. The substantiated rate of child abuse victims was 9.2 per 1,000 children nationally in 2012 while in Pennsylvania the substantiated rate of child abuse victims was 1.2 per 1,000 children. Pennsylvania had always been an apparent outlier because of its narrow definition of child abuse as well as who can be a perpetrator. For instance, the national substantiated child victim rate in 2000 was 12.2 per 1,000 children while Pennsylvania’s rate was 1.7 per 1,000 children — the lowest rate in the nation. Based on the Child Maltreatment 2012 data, Pennsylvania had fewer child abuse victims, who were 3 years of age or younger than the state of Delaware. That state recorded 732 victims between those ages, while Pennsylvania had 384. Meanwhile, New Jersey had 3,113 victims in this age group and Ohio recorded 9,440.
In 2013, multiple laws were passed to refine and broaden the definitions of child abuse. Those definitions and thresholds were meant to more accurately reflect the broader child abuse picture. In 2017 the national rate of child abuse investigations was 47.1 per 1,000 children while the substantiated rate was 9.1 per 1000 children. Pennsylvania’s rate of child abuse investigations in 2017 was 17.6 per 1000 children while the substantiated rate was 1.8 per 1,000 children which still is the lowest in the nation. There has been an 82% increase in the number of children receiving investigations from 2013 to 2017 in Pennsylvania. In 2017, the total number of substantiated child abuse victims in Pennsylvania was 4,836 whereas in Ohio it was 23,000 and in New Jersey 7,964.
Admittedly it is difficult to compare state statistics because laws and definitions vary. But Pennsylvania is still a significant outlier. Clearly, in spite of the changes in the law, there is still much work to be done on all levels. On a personal level, be a nurturing parent because children need to know that they are special, loved and capable of following their dreams; be helpful to a friend, neighbor or relative because parenting is not easy; be helpful to yourself by taking some time outs when life is overwhelming and out of control; be involved in your community to develop services to meet the needs of children and families; be an advocate for school programs that teach children, parents and teachers prevention strategies to keep children safe; be a volunteer at local child abuse prevention programs; be willing to report suspected abuse or neglect.
It is clear that our child protection system needs greater accountability and transparency including the review and evaluation of concerns voiced by children and families, mandated reporters, persons involved in the child protection system, and members of the general public that provide policymakers with information necessary to formulate systemic changes when appropriate. Children and Youth Services (CYS) needs adequate funding to protect and serve our children in a manner that keeps them safe, healthy and promotes their well-being. The work that CYS does is extremely difficult and at times extremely dangerous. For the most part CYS workers are underpaid and overworked. Perhaps there are persistent systemic problems within the child protection system that need to be addressed by developing a Pennsylvania Collaborative Dataset to measure and analyze child abuse trends that are accessible to clinicians, human services and researchers.
It is disheartening to realize that 50% of the children who died due to abuse over the last 8 years were in some way already involved with our child protection system. Perhaps it is time to restructure the approach to fatality and near-fatality reviews recognizing that each fatality should be viewed as the pinnacle of failure. Each fatality and near-fatality should require extensive multidisciplinary debriefs and root cause analysis. Finally, there is a need for the development of a Pennsylvania Cooperative Network that integrates Clinical Child Abuse Expertise within the Department of Human Services and the Legislature.
At a society level, there are many examples of research-based, effective preventive programs that help families create a healthy environment for themselves and their children (Nurse-Family Partnership and Incredible Years Parental Training for example). We have at our means the ability to identify high-risk families that would be candidates for voluntary preventative interventions. We must enhance these services, develop new ones, and make the investment to keep our children safe. Prevention is possible.
Pat Bruno is a pediatrician for Geisinger. He lives in Selinsgrove.