Former CDC Director Says NRA “Terrorized” Gun Violence Researchers

The Centers for Disease Control’s National Center for Injury Prevention and Control (NCIPC) has published numerous studies analyzing firearms-related deaths and injuries data, but over the last 16 years, the NCIPC hasn’t conducted a single study exploring why such acts of violence take place.

The reason, several former CDC directors say, is because pro-gun lobbyists made the topic of gun violence research forbidden through several measures adopted in the mid 1990s.

In 1996, several legislators co-sponsored an amendment that would cut the CDC’s budget, with a House Appropriations Committee adopting an additional amendment that prohibited CDC funding “to advocate or promote gun control.” Eventually, $2.6 million was removed from the CDC’s budget -- the exact amount that the NCIPC spent on firearms injuries studies a year prior.

The National Rifle Association (NRA) has long been critical of the CDC, with NRA executive vice president Wayne LaPierre recently telling the Atlanta Journal Constitution (AJC) that he believed the agency was promoting a political agenda through the NCIPC in 1995.

Other gun proponents agreed. Former Georgian congressman Bob Barr -- a member of the NRA board -- said that firearms violence is “nothing CDC should be involved in.”

“It has nothing to do with health,” he is quoted by the AJC. “I don’t think when the CDC was created there would by any contemplation that they would be studying firearms as a health issue.”

Several ex-CDC directors, however, claim that gun lobbyists have effectively eliminated any possibility of meaningful firearms research studies being conducted today, with former director of NCIPC Mark Rosenberg going as far as to say that “the scientific community has been terrorized by the NRA.

Dr. David Satcher, a CDC director when the budget cuts and amendments were passed, said that the restriction of research serves as a threat to both public health and democracy.

“It is sad when you really think about it,” he is quoted by the AJC. “We are in an environment when children are dying and we are playing political games.”

Today, researchers financed by the CDC are required to contact the agency when planning to publish firearms-related research. The CDC then forwards the information to the NRA “as a courtesy.”

RAND Corp.’s Arthur Kellermann said that now, the number of gun violence studies being published is just a fraction compared to the research released prior to the mid-1990s CDC budget cuts and amendments.

“It is almost impossible today to get federal funding for firearm injury prevention research,” he is quoted by the AJC. “I have to acknowledge that the (NRA) strategy of shutting down the pipeline of science was effective.”

Photo courtesy of Mike Saechang via Flickr.

Vaccines That Keep the Monsters of the Past at Bay

In 1867, a yellow fever epidemic swept Memphis… Across the street from me, ten persons lay dead from the plague. The dead surrounded us. They were buried in night quickly and without ceremony. All about my house at night I could hear weeping and the cries of delirium. One by one, my four little children sickened and died. I washed their little bodies and got them ready for burial. My husband caught the fever and died. I sat alone through the nights of grief. No one came to me. No one could. Other homes were as stricken as mine. All day, all night long, I heard the grating of the wheels of the death cart. -- Mary Jones, aka Mother Jones, from her autobiography.

Modern Americans don’t remember the panic and death associated with epidemics that once ravaged our country. Even as recently as 1952, which was my parent’s generation, people lived in the grip of fear as more then 59,000 cases of polio swept through all 48 states. Richard Aldrich, M.D., in his book, A Paralyzing Fear, wrote,

The first summer when I was home in Minnesota was that gosh-awful polio epidemic they had there. We admitted 464 proven cases of polio just at the University Hospital, which is unbelievable. And this was a very severe paralytic form. Maybe two or three hours after a lot of these kids would come in with a stiff neck or a fever, they’d be dead. It was unbelievable. It was just loads of people that came in, sometimes with only a fever but usually a headache and a little stiffness in the neck. And just absolutely terrified… A lot of people just took up and moved away, went to another city.

Parents were incapacitated by fears of children dying or being permanently scarred from childhood diseases such as chicken pox, hepatitis, polio, mumps, measles, meningitis, pneumonia or whooping cough. Before the invention of antibiotics, even the smallest scraped knee could quickly become fatal from infections. “… a little more than a century ago, the U.S. infant mortality rate was a staggering 20 percent, and the childhood mortality rate before age five was another disconcerting 20 percent,” according to Alexandra Stern, assistant professor of American Culture at the A Paralyzing Fear.

Parents today can’t imagine burying a child before age five because of common illnesses. We’ve become complacent, forgetting the huge medical advances brought about by antibiotics and vaccines.

In this climate, however, there is an anti-vaccination movement among today’s parents that may have long-term implications. Because parents fear a potential link between vaccinations and the rise in autism cases, many parents are opting out of giving vaccines. Since autism is now found in one in every 150 American children, there’s a lot of fear.  (For a deeper discussion on autism and its causes, here’s my article entitled The United States of Autism on JJIE.)

For more than 10 years researchers have been trying to determine if there’s a link between the vaccinations routinely given to infants and the increase in autism. According to the CDC,

“Because signs of autism may appear around the same time children receive the Measles, Mumps and Rubella (MMR) vaccination, some parents may worry that the vaccine causes autism. Vaccine safety experts, including experts at the CDC and the American Academy of Pediatrics, agree that the MMR vaccine is not responsible for recent increases in the number of children with autism.”

Recently in the New England Journal of Medicine, Dr. Saad Omer from Emory University warned that parents who don’t vaccinate might bring back illnesses that have almost been eradicated in the United States, often with deadly consequences. “Rates of exemption are substantially higher today than several years ago. Previously, rates were only rising in states with easy exemption policies, but now they are even rising in states that make it more difficult.”

Colorado, Washington, Minnesota and Wisconsin have been dealing with an extensive outbreak of pertussis, commonly known as whooping cough. The Wisconsin Department of Health Services reported 4,181 cases as of Sept. 3, 2012. This is 78 percent higher than the national average. Minnesota has reported 3,369 cases; Washington had 4,115 cases and 20 other states have reported cases of between 58 and 10 percent higher than the national average.

According to a 2008 CNN Report, “Currently, nearly one-half of 1 percent of kids enrolled in school are unvaccinated under a medical waiver; 2 to 3 percent have a nonmedical one, and the numbers appear to be rising.”

The need for vaccinations doesn’t end in the pediatrician’s office. “Moms on Meningitis” (or M.O.M.s), is hosting an awareness campaign to have freshmen vaccinated before ever heading to a college campus.  Lynn Bozof, the executive director of the National Meningitis Association, said, “We hope this awareness campaign will encourage parents to immunize their college-bound children against meningococcal meningitis.”

Bozof lost a son to the disease when he was a junior in college and said, “No parent should have to watch a child become permanently disfigured or die from this disease. Immunization has been around for years.”

For more information on vaccinations:

New CDC Report Shines Light on Teen Suicide Trends

A new report states that the number of attempted suicides by teens has dramatically increased in the last few years.

The report by the Centers for Disease Control and Prevention -- Youth Risk Behavior Surveillance - United States 2011, published last week in the agency’s Morbidity and Mortality Weekly Report -- examined several teenage suicide trends. It found the attempted suicide rate increased from 6.3 percent of the nation’s high school population in 2009 to 7.8 percent in 2011.

Additionally, the report finds that almost 16 percent of the nation’s high school students seriously considered attempting suicide in 2011, an increase from 13.8 percent just two years earlier.

Compared to 2009 statistics, researchers say that American high school students are generally more depressed, with more than a quarter of students reporting that they felt “sad or hopeless almost every day” for two or more weeks in a row. The 2011 figures, standing at 28.5 percent of the high school population, eclipse the estimates from two years ago, which stood at just 26 percent.

Last year, almost one-tenth of the nation’s female high schoolers attempted suicide, with younger students more likely to injure themselves than their older classmates, according to the report. Researchers say that in 2011, approximately 11.8 percent of female 9th graders and 11.6 percent of female 10th-graders attempted suicide, with 3.7 percent of 9th graders and 3.4 percent of 10th graders requiring medical attention.

According to the report, 13.5 percent of Hispanic female high school students attempted suicide last year, with four percent of the population requiring medical treatment for their injuries. Additionally, the report states that 21 percent of Hispanic female high schoolers considered attempting suicide last year, with 17.6 percent of the population making “serious plans” to injure themselves.

Alex Crosby, a medical epidemiologist at the CDC’s division of Violence Prevention, said that several factors, including acculturation and immigration processes, could be key stressors that lead Hispanic female teens to attempt suicide at elevated rates compared to the general population.

“Suicide is a complex behavior,” he said. “Almost always, there are multiple factors that play a role in a person engaging in suicidal behavior.”

Regarding the general increase in the number of teens attempting suicide in the United States, Crosby lists several factors, including juvenile drug use and the effects of the economic downturn on families.

“It may be multiple factors that play a role, whether it has to do with family stressors, school stressors [or] substance abuse issues,” Crosby said. “It could’ve been a combination, also, that could lead to an increase in the reports of suicidal behavior.”

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Addiction, Recovery and the Dangers Young People Face Today

Robotripping, dank, bath salts, spice, triple C’s, skittles, Roxies, Oxys, Xanibars, K2, if these names don’t sound familiar, the current trends in juvenile drug abuse are as surprising to you as they were to me.

A recovering addict myself, I was alarmed to learn what kinds of drugs are being used by our youth today.  The drugs are mostly synthetic, increasingly lethal, tend to require medically supervised withdrawal, and, in many cases, are undetectable by drug test.

In 2010, SAMHSA reported 10.1 percent of youths aged 12 to 17 were current illicit drug users.   That same year, the rate of current illicit drug use was higher among young adults aged 18 to 25, stood at 21.5 percent.

The rate of binge drinking in 2010 was 40.6 percent for young adults aged 18 to 25. Heavy alcohol use was reported by 13.6 percent of persons aged 18 to 25.  According to the CDC about 90 percent of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks. The National Institute on Alcohol and Drug Abuse reported 42 percent of college students report binge drinking in the previous two weeks.  All of them do not go on to become alcoholics. But enough of them do so that support systems in our schools and colleges are implemented

Detox, treatment, and on-going relapse prevention that includes 12-step meetings have been the path to freedom for thousands on the road to recovery. For many teens in recovery, returning to school means returning to the same environment they drank and used drugs in; a vulnerable position for someone new in recovery. Some communities are responding with Sober High Schools and many colleges have Collegiate Recovery Communities (CRC’s).

Dr. Kitty Harris, Director, Center for Study of Addiction and Recovery, Texas Tech University said recently that “going to college in early recovery is almost impossible without support.”

During a recent conference called Understanding and Responding to Young Adult Addiction and Recovery, held at Kennesaw State University in Georgia, Dr. Steven Lee, Program Director for Adult Psychiatric Partial Hospitalization Services and Young Adult Addiction Services at Ridgeview Hospital in suburban Atlanta, said “I have never seen anything like what I have witnessed over the last five years. More kids are using opiates, withdrawal is riskier and I have seen more children die.”

Education, a staunch repudiation of denial, community, and systems that support on-going recovery are needed to thwart these deadly threats to our children. Drugs, cheap drugs, are available in our homes (prescription medication), on-line (bath salts, K2) at the local head shop, and in our schools.

How do you know if a child is using drugs or alcohol? The nature of addiction is insidious and shrouded in denial making detection and diagnosis difficult. However, according to the National Council on Alcoholism and Drug Dependence there are some behavioral, physical and psychological signs to pay attention to:

Physical and health warning signs of drug abuse

  • Eyes that are bloodshot or pupils that are smaller or larger than normal.
  • Frequent nosebleeds -- could be related to snorted drugs (meth or cocaine).
  • Changes in appetite or sleep patterns. Sudden weight loss or weight gain.
  • Seizures without a history of epilepsy.
  • Deterioration in personal grooming or physical appearance.
  • Injuries/accidents and person won’t or can’t tell you how they got hurt.
  • Unusual smells on breath, body, or clothing.
  • Shakes, tremors, incoherent or slurred speech, impaired or unstable coordination.

Behavioral signs of drug abuse

  • Drop in attendance and performance at work or school; loss of interest in extracurricular activities, hobbies, sports or exercise; decreased motivation.
  • Complaints from co-workers, supervisors, teachers or classmates.
  • Unusual or unexplained need for money or financial problems; borrowing or stealing; missing money or valuables.
  • Silent, withdrawn, engaging in secretive or suspicious behaviors.
  • Sudden change in relationships, friends, favorite hangouts, and hobbies.
  • Frequently getting into trouble (arguments, fights, accidents, illegal activities).

Psychological warning signs of drug abuse

  • Unexplained change in personality or attitude.
  • Sudden mood changes, irritability, angry outbursts or laughing at nothing.
  • Periods of unusual hyperactivity or agitation.
  • Lack of motivation; inability to focus, appearing lethargic or “spaced out.”
  •  Appearing fearful, withdrawn, anxious, or paranoid, with no apparent reason.

Our youth in recovery face unique challenges. Getting clean and staying clean must be navigated around the joy seeking rite of passage adolescents and young adults experience. Peer acceptance, sorting out identity, having fun, and reconciling the wreckage of addiction to move forward must be addressed to embark upon a sustainable road to recovery.

The data from the existing programs are phenomenal. Dr. Harris reported a 97 percent recovery rate in the fall 2011 CRC students. Both Texas Tech and Kennesaw State reported higher grade point averages among CRC students versus the general student body.  Why all colleges do not have CRC’s and why more sober high schools are not in existence is evidence of the deep denial around this challenge. The statistics speak for themselves.

Detection, diagnosis, treatment, and long term support networks in our schools, colleges, and 12 step programs are our best defense against this scourge that is threatening, growing, impairing and killing our children.

Sharp Decline in Child Deaths From Unintentional Injury, CDC Finds

Fewer children are dying from unintentional injuries, according to a new report by the Centers for Disease Control and Prevention (CDC). A new Vital Signs report published by the CDC says death rates from unintentional injuries among children and adolescents from birth to age 19 declined by nearly 30 percent from 2000 to 2009, saving the lives of more than 11,000 children.

“In order to keep our kids safe from injuries we need two things: safer environments and knowledgeable parents,” Julie Gilchrist, a medical epidemiologist with the CDC’s Division of Unintentional Injury Prevention, said in a conference call with journalists. “Everyone has a role in keeping kids safe.”

More than 9,000 children in the United States died as a result of unintentional injury in 2009. The report does not include information on injuries from violence.

Motor vehicle crashes remain the most common cause of death from unintentional injury for children, the report says. However, improvements in child safety seats, increased booster seat use and the use of graduated drivers licensing systems for teen drivers in many states have all contributed to a 41 percent drop in deaths from 2000 to 2009.

Other leading causes of death resulting from unintentional injuries include suffocation, drowning, poisoning, fires and falls. The report says rates for most child unintentional injuries have been dropping but a few are on the rise.

Poisoning deaths, significantly, have increased by 91 percent among teens aged 15 to 19, largely as a result of prescription drug overdose, the report says.

Ileana Arias, the CDC’s principal deputy director, said prescription painkillers such as OxyContin and other opioids are the most abused by teens.

“Painkillers are essentially the driver of the prescription drug overdose problem,” Arias said, adding that, “Pain killers have replaced marijuana as the gatekeeper drug,” for many teens. Because many painkillers are opiate-based it is an easier for teens to graduate to harder drugs such as heroin that are also opiate-based.

But there are ways to keep kids safe and reduce deaths, the CDC says. Appropriate prescribing of medication, proper storage and disposal, discouraging medication sharing and state-based prescription drug monitoring programs are all valuable tools.

Among infants less than 1 year old, suffocation rates have risen sharply, up more than 50 percent.

“This is a troubling number,” Arias said. “Part of it may be due to improved investigations and classifications of infant deaths. Many of these would have been labeled SIDS [Sudden Infant Death Syndrome] in the past.”

A number of steps are available to parents to reduce the risk of suffocation for their children, according to the American Academy of Pediatrics. Infants should sleep in safe cribs, alone, on their backs with no loose bedding or soft toys, the Academy says.

The report also says emergency rooms in the United States treat a child for an injury every four seconds. A child dies as a result of an injury every hour.

In conjunction with the release of the Vital Signs report, the CDC, in partnership with more than 60 organizations, is releasing a National Action Plan on Child Injury Prevention. The plans goals are to:

  • Raise awareness about the problem of child injury and the effects on our nation.
  • Highlight prevention solutions by uniting stakeholders around a common set of goals and strategies.
  • Mobilize action on a national, coordinated effort to reduce child injury.

According to Gilchrist, the CDC's epidemiologist, everyone in the community has a role in keeping kids safe.

“There must be safe choices every time,” she said.

Photo by Flickr | Aaron of NEPA

The United States of Autism?

For 10 years the Centers for Disease Control and Prevention has been tracking the increase in diagnoses of autism in kids. Last month, the CDC released data showing that one in 88 children in the United States is being diagnosed with a cluster of symptoms associated with autism, which include:

• rigidity, or opposition to change

• difficulty interacting with others

• trouble making eye contact

• attachment to objects

• issues with language and self-expression.

The results are skewed towards boys, with one in 54 being diagnosed, as compared to one in 252 girls. This is a 23 percent increase in cases since the CDC’s last report in 2009. But more shockingly is the 78 percent increase since 2007. According to the CDC’s website, “Some of the increase is due to the way children are identified, diagnosed and served in their local communities, although exactly how much is due to these factors is unknown.”

This is a serious problem. In fact, some organizations are being overwhelmed. Mark Roithmayr, the president of Autism Speaks, says the number of diagnosis of the disorder “can now officially be declared an epidemic in the United States.”

The disorder was first studied in 1938 at the Vienna University Hospital by Hans Asperger. He has since had a specific set of symptoms named after him, Asperger’s Syndrome.  A person with Asperger’s will retain speech and cognition, but children with this grouping of symptoms will be characterized by an inability to “read” body language causing difficulty in social interaction, coupled with focused and repetitive interests. One child might be able to name all of the names of the dinosaurs, including their scientific names, but have no interest whatsoever in remembering the names of cousins or relatives.

Whatever the symptoms, the parents are the ones who can never take a day off from the disease. Since the behaviors can be so extreme and we have a culture of blaming parents for any bad behavior performed by their children, families with an autistic child may isolate themselves. As a mom copes with another screaming tantrum, it may be tempting to wonder why this child turned out this way and whether she did something wrong.

And there is the rub. Despite the years of studying this disorder, there isn’t a definitive answer for these parents who struggle every day to care for a child who may have quit talking 10 years before.

A small ray of hope has recently come with the announcement in the journal Nature about ground breaking research that finally identified gene mutations as one of the causes.

If someone you love is experiencing some of the behaviors associated with autism, run don’t walk, to the nearest authoritative resource today to start learning how to intervene to have the best outcome for your child. A diagnosis before age three is recommended to provide resources and intervention. There are various ranges of this disorder. Some live cocooned in their own little worlds while others, such as Temple Grandin, who eventually earned her PhD, function perfectly fine in society.

We may never know why one child develops the symptoms of autism, while a brother or sister does not. And, we may never know exactly how to cure the child. But, let’s not take away from the humanity of those children by labeling or shelving them for the rest of their lives. And, let’s give the parents of an autistic child a day off. Support your local autism resource center by volunteering one day a week, one day a month or by sending in a donation. Every little bit is needed to lift a little bit of the burden felt by the parents of the one in 88.





Autism Spectrum Disorder Rates Increasing, CDC Report Finds

According to new Centers for Disease Control data, the prevalence rates for autism spectrum disorders (ASD) in children has increased, with an estimated one in 88 eight-year-olds in the United States currently diagnosed with an ASD such as autism or Asperger’s syndrome.

In a Surveillance Summary published last week in the Morbidity and Mortality Report, the CDC notes a 23 percent jump in autism spectrum disorder diagnoses from 2006 to 2008, with an estimated 78 percent increase in cases from 2002 to 2008.

According to the findings, the diagnosis rates between black and Hispanic children and whites are closing, with African-American children being diagnosed at a rate of 10.2 cases per 1,000 compared to 12 cases per 1,000 for Caucasian children. The new data reports that 7.9 in 1,000 Hispanic children may be affected by disorders such as autism, Asperger’s syndrome or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS ).

According to the findings, boys are five times more likely than girls to be diagnosed with autism or Asperger’s syndrome. The report also finds that among 8-year-old boys, regardless of ethnicity, one in 54 may have an autism spectrum disorder.

The report was based on surveillance network statistics compiled from 14 sites across the United States. The Autism and Developmental Disabilities Monitoring (ADDM) Network, which analyzes rates among eight-year-olds at specified surveillance sites every two years, is currently collecting data for a report on diagnosis rates from 2010. The ADMM Network is also in the process of compiling information for its first ever report on ASD rates among four-year-olds.

“Estimates of ASD continue to increase in the majority of ADDM Network communities, and ongoing public health surveillance is needed to quantify and understand these changes over time,” the report said. “Further work is needed to evaluate multiple factors affecting ASD prevalence over time.”

Federal Judge Strikes Down Mandatory Cigarette Health Warning Labels

This week a federal judge ruled in favor of tobacco companies challenging a FDA requirement that would force cigarette manufacturers to place graphic warning labels on their products.

“The government has failed to carry both its burden of demonstrating a compelling interest and its burden of demonstrating that the rule is narrowly tailored to achieve a constitutionally permissible form of compelled commercial speech," U.S. District Judge Richard J. Leon said.

The ruling stems from a 2009 law passed by Congress that required the FDA to enforce new warning requirements, which included manufacturers placing color labels on their products which covered at least half of the packaging space, as well as on 20 percent of print advertisements for cigarettes.

Last summer, the FDA unveiled nine warning labels – among them, photographs of charred lungs and corpses – that were expected to be placed on all cigarette packages in the United States by September 2012. Last year, Judge Leon allowed a preliminary injunction which prevented the mandatory warnings from being placed on tobacco products, a decision challenged by the Obama administration and currently awaiting a U.S. Court of Appeals for the District of Columbia Circuit ruling.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, slammed this week’s decision, stating that the ruling “ignores decades of First Amendment precedent that support the right of the government to require strong warning labels to protect the public health.”

The United States Department of Health & Human Services was also critical of the ruling, announcing that the organization would “do everything we can to warn young people about the dangers of smoking” in a recent press release.

“This public health initiative will be an effective tool in our efforts to stop teenagers from starting in the first place and taking up this deadly habit,” the HHS release read. “We are confident that efforts to stop these important warnings from going forward will ultimately fail”

The Centers for Disease Control and Prevention estimate that almost 45 million adults smoke cigarettes in the United States, which the CDC also lists as the leading cause of preventable death in the nation.

According to the most recent CDC data, approximately 4,000 children smoke their first cigarette every day in America, with a quarter of them eventually becoming daily users.

New Report Shows the Crippling Cost of Child Abuse

This month the Centers for Disease Control and Prevention (CDC) released a report quantifying the costs of child maltreatment in the United States. The report underscores that child maltreatment is a serious public health issue with financial impacts comparable to a stroke and Type 2 diabetes.

What the report does not quantify is the loss of a child’s innocence. What is the price of the smile on a baby’s face when he takes his first steps, or on the 8-year-old who scores her first goal, or on the 12-year-old who wins his class spelling bee? What about the joy and love brought into the lives of family and friends by that child? And what about the loss to all who might have been helped because the abused toddler may have grown up to cure cancer or end child abuse?

Actuarial calculations are useful for placing child maltreatment in the context of other public health and public safety concerns. They serve as a proxy for the lives of children in policy and budget decisions. When the final budget is passed at the end of this legislative session, how will child maltreatment compare with other priorities?

The CDC study examined confirmed new cases of child abuse and neglect in 2008 and estimated that the total lifetime cost for fatal and nonfatal abuse occurring in 2008 was at least $124 billion. In addition to medical expenses for the life of the child victim, the calculated costs included expenses of the child welfare, criminal justice, and special education systems, as well as productivity losses during the lives of victims. The study’s many limitations caused the estimated costs to be quite conservative. Knowing that the incidence of child maltreatment is much greater than the number of confirmed cases, the study says that the actual cost is closer to $585 billion instead of $124 billion.

In Georgia, where I have worked, in federal fiscal year 2011, approximately 19,000 children were confirmed victims of child maltreatment. Using the CDC calculations, if all these victims lived, the lifetime cost of this abuse will be nearly $4 billion. If 60 of those children died from abuse or neglect, which is about how many children the Department of Human Services identified as dying of maltreatment in 2008 and also in 2009, the total lifetime cost of child maltreatment in Georgia during FFY 2011 would be almost $4.1 billion.

Our community cannot afford the emotional or financial costs of child abuse. Preventing child abuse is our collective responsibility. Together we must figure out how to help our neighbors, support those who are most at risk of abuse and neglect, and protect all children by increasing the presence of five protective factors in our communities and families. These protective factors act as buffers against child maltreatment: social connections, knowledge of parenting and child development, parental resilience, nurturing and attachment, concrete supports for parents.

Elected officials play a particularly important role in preventing child abuse because the laws they pass define child maltreatment and determine how much the state will spend on prevention and intervention. This session, legislators are considering several bills discussing child abuse and neglect, including SB 127 and companion bill HB 641, which would revise Georgia’s Juvenile Code, and several bills addressing who is required to report child abuse and how the Department of Human Resources responds to such reports. Bills that call for educating children about the consequences of sexting and dating violence also help reduce child maltreatment. In addition, bills addressing the charging, processing, and treatment of children accused of committing delinquent acts figure into the future costs of child maltreatment because of the porous nature of the artificial divide between deprivation and delinquency.

While the role of lawmakers is higher profile than the neighbor who helps an overwhelmed mother with her energetic twins, or the Family Visitation Services/SafeCare home visitor who teaches a father how to comfort his crying newborn, each of these people, and you and I, plays a critical role in reducing the financial and emotional burdens of child abuse and neglect.

Enrollment in Kids’ Health Insurance Programs Grow Under Medicaid Bonus Program

Last month, the Centers for Medicare & Medicaid Services awarded 23 states approximately $296 million in bonuses for increasing the number of children enrolled in health insurance programs.

The bonuses, funded by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), came a week after the Centers for Disease Control and Prevention released a report stating that about 1.2 million more children have health insurance in the United States than three years prior.

According to the most recent estimates, approximately 93 percent of the nation’s children now have some form of health insurance coverage, a 2 percent increase from federal levels around 2008. When the Children’s Health Insurance Program was initially created in 1997, the national statistics hovered around 86 percent.

In addition to providing performance bonuses for states that simplify and increase coverage for children, CHIRPA provisions allow states to enroll children using information culled from other public programs, as well as automatic eligibility for babies whose mothers are already covered by Medicaid or CHIP programs.

Cindy Mann, deputy administrator of the Centers for Medicare & Medicaid Services, said that although the nation faces “serious fiscal challenges,” she still believes that children’s health should remain “a top priority” for states. “Not only have more states qualified for performance bonuses in the past,” she said, “but many have continued to improve the efficiency of their programs.”

In 2010, the Centers for Medicare & Medicaid Services awarded more than $217 million in CHIPRA Performance Bonuses to 16 states, all of which qualified for performance bonuses again in 2011.

States qualifying for FY2011 CHIPRA Performance Bonuses include: Alabama, Alaska, Colorado, Connecticut, Georgia, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, Virginia, Washington and Wisconsin.

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