Child Abuse: Our Nation’s Largest Public Health Problem

Child Abuse:
Our Nation’s Largest Public Health Problem
The first time I heard Robert Anda present the results of the ACE study, he could not hold back his tears. In his career at the CDC he had previously worked in several major risk areas, including tobacco research and cardio-vascular health. But when the ADA data started to appear on his computer screen, he realized that they had stumbled upon the gravest and most costly public health in the USA: Child Abuse. He had calculated that its overall costs exceeded those of cancer and heart disease and eradicating child abuse in the USA would reduce the overall rate of depression by more than half, alcoholism by two thirds, and suicide, IV drug use and domestic violence by three-quarters. It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration.

When the surgeon general’s report on smoking and health was published in 1964, it unleashed a decades-long legal and medical campaign that has changed daily life and long-term health prospects for millions. The number of American smokers fell from 42% of adults in 1965 to 19% in 2010, and it is estimated that nearly 800,000 deaths from lung cancer were prevented between 1975 and 2000.

The ACE study, however, had no such effect. Follow up studies and papers are still appearing around the world, but the day-to-day reality of children in outpatient clinics and residential treatment centers around the country remains virtually the same. Only now they receive high doses of psychotropic agents, which makes them more tractable but which also impairs their ability to feel pleasure and curiosity, to grow and develop emotionally and intellectually, and become contributing members of society.

Dr. Bessel Van de Kolk