By Aly Hill and Meredith Muller
A mother holding a baby
Each year in the United States, more than 600,000 children are victims of child abuse. Nationally, more than one-third (34.2%) of child maltreatment victims are three years old or younger, with children under one year old accounting for 14.9 percent of all victims. These data are troubling among young children for whom early brain development is essential to long-term health outcomes.
Failure to mitigate maltreatment among young children is largely the result of programs that emphasize intervention rather than prevention. While many well-supported interventions can prevent out-of-home placement and, in some cases, reduce subsequent maltreatment, intervention that begins after an incident of child maltreatment may not mitigate the range of associated negative outcomes.
An independent research brief recently published by the Sorenson Impact Center identified several caregiver risk factors leading to incidents of child maltreatment. Of the fifteen studies reviewed in the report, eight reported low socioeconomic status as being a statistically significant predictor of child maltreatment. As well, young caregiver age was associated with an increased risk of child maltreatment in three of the studies, as was marital status and/or paternal uncertainty.
Indeed, child maltreatment and physical abuse have been linked to several long-term health consequences, such as higher risk for diabetes, lung disease, functional limitations, as well as diminished executive functioning and cognitive skills, poor mental and emotional health, post-traumatic stress, adult criminality, and more.
Moreover, adults with documented histories of childhood abuse and neglect may have lower levels of education, employment, and earnings, with many children who are victims of abuse requiring special education and early intervention services to address developmental delays. Maltreated children are also more likely to engage in juvenile delinquency and adult criminal behavior and are disproportionately more likely to experience homelessness as adults, demonstrating the need for more effective preventative programming.
To mitigate instances of child maltreatment programs designed with prevention in mind, mean renewed hope for children and caregivers alike.
A Focus on Prevention
Primary prevention strategies that provide intervention services to high-risk families before an incident of reported maltreatment can reduce and mitigate the adverse effects of child maltreatment in the most vulnerable age group.
Providing evidence-based prevention services to pregnant women exhibiting these risk factors can mitigate the parental and family risk factors shown to be associated with child maltreatment, improving short- and long-term outcomes and reducing the long-term monetary costs to taxpayers and individuals associated with child maltreatment. Nurse-Family Partnership, a prevention-based early home visiting program, is leading the solution, according to the latest research brief produced by the Sorenson Impact Center.
The Solution in Practice
Classified as “well-supported” under the Department of Health and Human Services (HHS) Clearinghouse, Nurse-Family Partnership ® (NFP) serves first-time moms and their children affected by social and economic inequality. Each nurse promotes confidence within the new parent to achieve healthy outcomes and better opportunities for both parent and baby.
Among all well-supported home visiting programs, NFP is the most effective home visiting program in reducing the incidence of child neglect, maltreatment, and maltreatment fatalities, according to Sorenson's research.
Research shows that NFP is effective in reducing the incidence of child abuse and neglect as well as reducing childhood injuries. In long term follow-up studies, NFP is shown to reduce state-verified rates of child abuse and neglect by 48% with a 56% reduction in emergency visits for accidents and poisonings in the child’s second year of life. Furthermore, NFP was the only program identified by the Federal Commission to Eliminate Child Abuse and Neglect Fatalities as proven to reduce child maltreatment fatalities and the only “well-supported” program specifically targeting the most at-risk populations. Aiming to serve the families most affected by socioeconomic challenges and barriers to resources, NFP programming is tailored to those at the highest risk for maltreatment, distinguishing them from similar home visiting programs.
Sorenson Impact’s research revealed that NFP’s emphasis on prevention rather than intervention also contributes to long-term cost savings for caregivers. A cost-benefit analysis conducted by New Mexico on the returns of child welfare programs showed a benefit-cost ratio of $9.7 to $1 for NFP, a greater benefit-cost ratio when compared with other home visiting programs. The fiscal and monetary benefits (to taxpayers and participants) associated with the reduction of child maltreatment equal 98% of the annual costs of the NFP program, as much as 30% to 70% higher than other home visiting programs. In addition, a cost-effectiveness analysis shows NFP’s program achieves reduction in child maltreatment at a 2.2 to 5.8 times lower cost per outcome when compared to other home visiting programs. But for NFP clients, the impact on their child is invaluable.
Breaking The Cycle
Having served more than 366,500 families, “Nurse-Family Partnership’s intervention offers a multigenerational effect,” said Frank Daidone, president and CEO of the National Service Office for Nurse-Family Partnership and Child First. “Nurses support expecting parents with building the lives they want for themselves and their children. This long-lasting early intervention can be seen for many generations to come.” By breaking the cycle, NFP has bolstered improved outcomes for caregivers and babies.
In their more than 45 years of programming, NFP has successfully improved maternal and child health outcomes, including reducing child abuse and improving child development and school readiness, moving the needle toward long-term success.
“I want to teach her that she deserves the world – to learn love. Because I had a hard time learning that growing up,” said one NFP mom.
Research for the Child Maltreatment Strategy was conducted independently by the Sorenson Impact Center using primarily publicly available data. Findings were reviewed by the National Service Office for Nurse-Family Partnership and Child First with whom the Center maintains a consulting relationship.
Read the Sorenson Impact Center brief here.
