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Reducing Violence: Issues, Options, and Opportunities for State Governments

Child Abuse & Suicide Prevention

Presenters:

David Olds, Ph.D., Professor of Pediatrics, Psychiatry and Preventive Medicine, and Director, Prevention Research Center for Family and Child Health, University of Colorado Health Science Center, Denver, CO.

Lloyd B. Potter, Ph.D., M.P.H., Team Leader, Youth Violence and Suicide Prevention, Centers for Disease Control and Prevention, Atlanta, GA.


Home-visiting may be able to reduce the incidence of child abuse as indicated by the success of a 23-year-old program implemented in Elmira, New York, that uses nurse home-visiting to address the following problems:

  • Pre-term delivery and low birthweight.
  • Child abuse and neglect.
  • Childhood injuries.
  • Rapid successive unintended pregnancy.
  • School failure and reduced participation in the workforce.

Dr. Olds's research shows that the program has been effective in areas that were targeted for improvement as well as other important areas not specifically targeted. The results from the Elmira study show:

  • A reduced smoking rate in mothers.
  • Improved diet for both mothers and babies.
  • Increased social support for mothers.
  • Increased involvement with formal services available to mothers.
  • A reduction in the number of pre-term deliveries.
  • Increased birthweight in the babies of young teens.
  • A reduction of 80 percent in child maltreatment by poor, young mothers.
  • A 56-percent reduction in emergency room visits for children in the program.

Dr. Olds' research team has observed similar results in other locations in which the program has been tried, even after taking the changes in demographics between the various pilot sites into consideration.

Dr. Lloyd Potter, discussing suicide and its importance on the national agenda, showed that suicide is the eighth leading cause of death in the country, affecting millions of people each year. The Centers for Disease Control and Prevention is behind a substantial national push to focus attention more closely on issues of suicide, which includes programs that incorporate components of:

  • Screening.
  • Peer support.
  • General education.
  • Crisis intervention.
  • Restriction of access to lethal means (guns, drugs, etc.).

A key point made by Dr. Potter was that reducing violence within all areas will assist in the reduction of the rates of suicide, as they are intimately connected.

References:

Clarke J, et al. Victims as Victimizers: Physical Aggression by Persons With a History of Childhood Abuse. Intern Med 1999;159(16):1920-4.

Kitzman H, et al. Effect of Prenatal and Infancy Home Visitation by Nurses on Pregnancy Outcomes, Childhood Injuries, and Repeated Childbearing. JAMA 1997;278(8):644-52.

Olds D, et al. Long-term Effects of Home Visitation on Maternal Life Course and Child Abuse and Neglect. JAMA 1997;278(8):637-43.

Olds D, et al. Long-term Effects of Nurse Home Visitation on Children's Criminal and Antisocial Behavior. JAMA 1998;280(14):1238-44.

Olds D, et al. Prenatal and Infancy Home Visitation by Nurses: Recent Findings. The Future of Children 1999;9(1):44-65.


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