Community Blueprint for Children: Creating a Systematic, Comprehensive, Proactive Approach to Child Safety in Santa Cruz County

Child abuse is one of the most challenging public health, mental health, and social issues facing our community.  Long term mental health outcomes for people abused in childhood include depression, anxiety, suicidality, post traumatic stress disorder, and dissociative identity disorder.  Recent studies have demonstrated a strong correlation between childhood abuse and many of the leading causes of illness and death in adulthood, including increased risk of heart disease, cancer, lung disease, and liver disease.  There is also a clear link between childhood abuse and unhealthy behaviors in adulthood including obesity, risky sexual behavior, drug and alcohol abuse, and smoking.  In Santa Cruz County our child abuse rates exceed state averages and have seen an upward trend over many years.

Children thrive when they have their many needs met adequately.  Children need love, attention, nurturing, connection, bonding, opportunities to learn, support for healthy social interactions, and consistency.  For most of human history, each child received attention and caregiving from many adults in the tribe.  With the support of an extended community, parents learned how to nurture their infants and children, and had support from others when they needed respite.  In today’s fast paced society, many families struggle without much support from an extended community.  The demands of childrearing must be juggled with many other conflicting demands.  Stresses mount, and sometimes children are hurt as a result.  Child abuse and neglect occurs in families of every race, economic level, and educational level.  All families need support, and all children can benefit by a systematic approach to child abuse prevention.

One way to understand the scope and consequences of child abuse is to review the childhood histories of adults and compare these histories with physical and mental health outcomes and behaviors in adulthood.  The ACE study, a collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente, looks at adverse childhood experiences, health behaviors, and physical health outcomes.  This research was initiated at Kaiser Permanente from 1995 to 1997, and its participants are over 17,000 members who were undergoing a standardized physical examination. No further participants are being enrolled, but there is continuous tracking of the medical status of the baseline participants.

Each study participant completed a confidential survey that contained questions about childhood maltreatment and family dysfunction, as well as items detailing their current health status and behaviors. This information was combined with the results of their physical examination to form the baseline data for the study.  One of the most startling findings of this study is that almost two thirds of study participants had suffered from at least one form of adverse childhood experience, and twenty percent had suffered three or more.  The following chart breaks out the percentages of HMO patients who had suffered various forms of child abuse.

Relationship of Child Abuse to Long Term Health Outcomes

The short- and long-term outcomes of these childhood exposures include a multitude of health and social problems. The ACE Study has demonstrated that as the number of Adverse Childhood Experiences increases, the risk for the following health problems increases as well:

1. alcoholism and alcohol abuse
2. chronic obstructive pulmonary disease (COPD)
3. depression
4. fetal death
5. illicit drug use
6. ischemic heart disease (IHD)
7. liver disease
8. risk for intimate partner violence
9. multiple sexual partners
10. sexually transmitted diseases (STDs)
11. smoking
12. suicide attempts
13. unintended pregnancies

The ACE Study has also demonstrated that the number of adverse childhood experiences a person has directly correlates with to poor health-related behaviors and outcomes during childhood and adolescence including early initiation of smoking, sexual activity, and illicit drug use, adolescent pregnancies, and suicide attempts.

Clearly it is crucial that our community takes a proactive stance to prevent abuse before it occurs.  Many community agencies are working with families to reduce risk factors and increase protective factors, however a systematic approach is called for so that we can support all families and insure that all children are safe, healthy, and thriving.  To create a plan to fill that need and build community support for its implementation, a group of leaders was convened in December, 2006, under leadership of the Child Abuse Prevention Council (CAPC) and Court Appointed Special Advocates (CASA).   Naming their effort Community Blueprint for Children (CBC), the group consists of:

1. Beth Love, Santa Cruz County Child Abuse Prevention Council
2. Nancy Sherrod, Court Appointed Special Advocates
3. Erika Hearon, Family Resource Network
4. Susan True, First 5 Santa Cruz County
5. Lynn McKibbon, County of Santa Cruz Health Services Agency, Maternal Child and Adolescent Health
6. Sherra Clinton, County of Santa Cruz Human Resources Agency, Family and Children’s Services Division

This group, the CBC Preplanning Team, has been meeting over the last year to research best practices in the field, develop a theory of change/logic model, and design the planning process.  Beginning in September, 2007, staff and interns at the Child Abuse Prevention Council are leading the assessment phase of Community Blueprint for Children.  Through extensive interviews with over two dozen community service providers and a wide variety of additional informants, the current state of child abuse prevention strategies in our county is being mapped. 

In the next phase, beginning in early 2008, a broad group of community stakeholders will review the research into best practices and analyze the current status of community prevention efforts in Santa Cruz County.  This will include traditional partners such as agencies serving families, educators, health providers and non-traditional partners such as faith-based community members, businesses, and community groups.  People who have contact with families early in the family cycle will be especially necessary, as our strategies will need to positively impact families before trouble occurs.
Gaps will be identified and a plan for a systematic, comprehensive approach will be developed with both short term and long term goals and outcomes that will benefit families and children.

While this is a very ambitious undertaking, our entire community will benefit from an increased, coordinated, strategic effort to ensure thriving families.  We all bear immense economic and social costs when children do not grow up in nurturing, safe homes. 

For More Information:

Beth Love, Executive Director
Santa Cruz County Child Abuse Prevention Council
2825 Porter Street, Suite B
Soquel, CA  95073
(831) 464-1737
beth_capc@baymoon.com

Nancy Sherrod, Executive Director
Court Appointed Special Advocates
(831) 761-2956  x 101
294 Green Valley Rd., Suite 326
Watsonville, CA 95076
FAX: 761-2913
nancys@casaofsantacruz.org