The Health CARES Network
Child Abuse Research, Education, and Services

A printable version of this fact sheet is available to the right, and can be used as a leave behind when meeting with members of Congress.

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A Proposal for Federal Investment in a National Health Care Infrastructureto Reduce the Health Harms Resulting From Child Abuse and Neglect

The Health Harms: The physical and emotional harm to children that results from abuse and neglect is well documented. However, new research from the Centers for Disease Control and Prevention (CDC) demonstrates additional lifelong health harms that result in significantly increased rates of morbidity and mortality for adults. The health harms experienced by abused and neglected children throughout their lives constitute a national health care crisis that calls for a major response from the field of health care.

The Obstacles to Reducing the Health Harms: Most of the current national investment in child abuse prevention and treatment focuses on the legal and social welfare responses but not the health care response. As a consequence, major obstacles to the health care field currently impede the health and public health sector efforts to reduce the health harms identified with child abuse and neglect:

• Research - Because health and public health efforts targeting child abuse and neglect lack resources and a national infrastructure, there is only limited health care research into the development and testing of evidence-based health care approaches to child abuse prevention, identification, and treatment.

• Workforce - Because health and public health efforts targeting child abuse and neglect lack resources and a national infrastructure, the nation is not educating sufficient numbers of health care professionals to replace the current generation working on child abuse prevention, identification, and treatment, much less meet the increased need.

• Services - Because health and public health efforts targeting child abuse and neglect lack resources and a national infrastructure, there is only limited ability to promote evidence-based “best practices” of child abuse diagnosis and treatment by primary and secondary health care providers. Both over- and underdiagnosis of child abuse and neglect must be zealously avoided. Accurate diagnosis protects both abused children and those falsely accused of abuse.

• Prevention - Because health and public health efforts targeting child abuse and neglect lack resources and a national infrastructure, there is only limited integration of prevention into children’s primary health care. There is much left to be learned about prevention. Failure to prevent child maltreatment results in great human suffering; large costs in the social service, legal, and health systems; and lost productivity. The health care system is ideally positioned to play an important role in child abuse and neglect prevention. The health care system has contact with most of the population from before birth. Frequent visits for immunizations and routine health care during childhood provide an opportunity to educate parents, children and adolescents, and to prevent child abuse and neglect.

The Needed National Infrastructure - The Health CARES Network
Pediatric health care leaders strongly recommend an annual federal investment to create the Health Child Abuse Research, Education, and Services (CARES) Network. The Health CARES Network will consist of regional consortia, each comprising multiple institutions that bring together expertise in health care research, training, and service to prevent, identify, and treat child abuse. The network’s purpose is to fulfill measurable goals for increasing the workforce; fostering systematic development of evidence-based prevention, identification, and treatment; and incorporating these advances into health care delivery for all children.

This network is modeled after the decades-old federal investment in the national network of University Centers of Excellence in Developmental Disabilities Education, Research, and Service. In this successful program, federal funds establish centers, finance training, support research capacity and projects, fund innovative service delivery, and facilitate collaboration among centers to strengthen work in each of these areas. A similar infrastructure is essential if the health care field is to fulfill its unique potential to reduce the health harms that result from child abuse and neglect.

The Health CARES Network will:

• significantly expand and improve the health and public health efforts to reduce the health harms of child abuse and neglect.
• assist the social services, legal, and education sectors with enhanced knowledge and additional well-trained professionals in the multiple disciplines addressing child abuse.
• emphasize and fund health care research and training of health care professionals, but not fund child abuse health-related care. This will require careful evaluation of all specific methods and the maximum use of evidence-based practice for child maltreatment prevention, identification, and treatment.
• improve the processes of diagnosis, treatment, and prevention of all forms of child maltreatment by developing new knowledge and integrating best practices. This will include supporting parents and preventing child abuse through integrating effective anticipatory guidance into the primary health care systems.
• require the development of regional consortia consisting of collaborations among pediatric academic programs, hospitals, and primary care delivery systems. The institutions and programs working together to form regional CARES consortia will vary to reflect the needs, resources, and opportunities for collaboration that exist in different regions of the country. The consortia will themselves form a network for cooperative research and effort. Support for these will achieve the critical mass of training, leadership, and geographic diversity needed to significantly advance the prevention, identification, and treatment of child abuse and neglect throughout the nation.

For more information about the Health CARES Network, please contact Cindy Pellegrini, AAP Department of Federal Affairs, 800-336-5475, ext. 3307, or cpellegrini@aap.org.