A public health approach to protecting children

How do we protect children and young people from abuse and neglect?

Across Australia, statutory child protection services in each state and territory receive mandatory reports and other notifications about potential harm to children and young people. These services investigate and respond to ensure their safety. There are also many dedicated professionals and agencies involved in addressing known risk factors (domestic and family violence, parental mental health, drug and alcohol misuse) that expose children and young people to harmful environments including maltreatment by parents, caregivers, and worker/volunteers in youth-serving organisations.

However, the prevention of child maltreatment can be further enhanced by a public health approach that draws on the trust-and reach-of services where children and families are already engaging. These services include early childhood education, schools, GPs, and other medical/health services such as maternal and child health. These agencies have the capacity to provide evidence-based parenting and family support.

For children to thrive, their parents and carers need help to navigate the tricky waters of parenting and care. But to get that support, they shouldn't have to be seen as bad, or failing. Neither should this support be mandated through a statutory child service. Such an approach can be implemented through a prevention model that combines universal and targeted positive parenting interventions to protect children.

The Institute of Child Protection Studies is investigating and advocating a multi-level public health approach, led by Professor Daryl Higgins. Child abuse and neglect can be prevented by providing supports for parents and carers on multiple levels. Based on the following principles, public health-oriented child prevention strategies should be:

1. Population based: learning and adapting similar population-level strategies
2. Proportionate and progressive: applying interventions at universal, secondary and tertiary levels
3. Prevention focused: understanding the causes of child maltreatment and poor child wellbeing
4. Partnership based: supporting partnerships across different services and sectors
5. Practice aligned: identifying innovative practice frameworks and prevention platforms 

We know that a public health approach to complex health issues works; a public health strategy was applied to tobacco-related cancers, road accidents/fatalities, dental carries and STDs/HIV and helped minimise their harm at a population level. Protecting children is perhaps even more complex. But it requires engagement from different government portfolios, service providers and the community.

Successful prevention strategies, services and programs need to address the diverse cultural needs, political environments and community expectations of our society. Services within different institutional and community contexts need greater support to build expertise in implementing a range of programs. Although parenting programs and supports can have a positive impact, participation needs to be normalised, destigmatised, and made widely accessible through concerted government commitment.

Presentations

Parenting and Family Research Alliance (2021). Thriving futures for kids and families: The role of evidence-based parenting and family intervention. Recording of webinar by Parenting and Family Support Centre, The University of Queensland (13 July 2021). https://www.pafra.org/seminar-2021-pfsc

Higgins, D. & Griffths-Cook, J. (2020). Re-imagining public health in the ACT. Recording of webinar Child Protection Week (28 October 2020). https://www.acu.edu.au/about-acu/institutes-academies-and-centres/institute-of-child-protection-studies/publications/publications-by-format-type/videos

Higgins, D. & Parton, N. (2020). Putting children first: the primary prevention paradox. Recording of presentation at National Child Protection Week (7 September 2020). https://youtu.be/aEUbcxgL7QI

Higgins, D. (2020, 11 March). If I wrote the blueprint, I would say… Panel presentation at The National Early Years Summit: Working together for their first 1000 days and beyond. Albert Park, Melbourne: ARACY. https://www.aracy.org.au/events/event/national-early-years-summit-2020

Higgins, D. (2019). A public health approach to child safety: 7 components of a public health approach. Recording of presentation at National Child Protection Conference (Brisbane, 24-25 June). https://youtu.be/B5D4iMPRI5g

Publications

2022

Doyle, F.L., Morawska, A., Higgins, D.J., Havighurst, S.S., Mazzucchelli, T.G., Toumbourou, J. W., Cobham, V.E., Middeldorp, C.M., Harnett, P. (2022). Policies are Needed to Increase the Reach and Impact of Evidence-Based Parenting Supports: A Call for a Population-Based Approach to Supporting Parents, Children, and Families. Child Psychiatry and Human Development. https://doi.org/10.1007/s10578-021-01309-0 [View infographic of paper]

Higgins, D., Lonne, B., Scott, D., Herrenkohl, T. & Klika, B. (2022). Core Components of Public Health Approaches to Preventing Child Abuse and Neglect. In R. Krugman, & J. Korbin, (Eds.) Handbook of Child Maltreatment (Ch 22), 2nd Edition. Springer.

Lonne, B., Herrenkohl, T.I., Higgins, D.J., Klika, J. B. & Scott, D. (2022). Issue editors of International Journal on Child Maltreatment.

Lonne, B., Herrenkohl, T.I., Higgins, D.J., & Scott, D. (2022).The Implications of Leveraging Administrative Data for Public Health Approaches to Protecting Children: Sleepwalking into Quicksand? International Journal on Child Maltreatment. DOI: 10.1007/s42448-022-00126-9

Mathews, B., MacMillan, H. L., Meinck, F., Finkelhor, D., Haslam, D., Tonmyr, L., Gonzalez, A., Afifi, T. O., Scott, J. G., Pacella, R. E., Higgins, D., Thomas, H., Collin-Vézina, D., & Walsh, K. (2022). The ethics of child maltreatment surveys in relation to participant distress: Implications of social science evidence, ethical guidelines, and law. Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2021.105424

2021

Mathews B, Pacella R, Dunne M, Scott J, Finkelhor D, Meinck F, Higgins DJ, Erskine H, Thomas HJ, Haslam D, Tran N, Le H, Honey N, Kellard K, Lawrence D. (2021) The Australian Child Maltreatment Study (ACMS): protocol for a national survey of the prevalence of child abuse and neglect, associated mental disorders and physical health problems, and burden of disease. BMJ Open. 11:11(5):e047074. doi: 10.1136/bmjopen-2020-047074

2020

Herrenkohl, T., Scott, D., Higgins, D., Klika, B., & Lonne, B. (2020). How COVID-19 is placing vulnerable children at risk and why we need a new approach to child welfare. Child Maltreatment. https://journals.sagepub.com/doi/10.1177/1077559520963916

Herenkohl, T. I., Lonne, B., Higgins, D., & Scott, D. (2020). The personal security of children demands bold system reform. International Journal on Child Maltreatment: Research, Policy and Practice 3, 9-17. https://doi.org/10.1007/s42448-019-00027-4

2019

Higgins, D., Sanders, M., Lonne, B., & Richardson, D. (2019). Families - private and sacred: How to raise the curtain and implement family support from a public health perspective. In B. Lonne, D. Scott, D. Higgins, & T. Herrenkohl (Eds.) (2019). Re-visioning public health approaches for protecting children (Ch. 9). Child Maltreatment 9: Contemporary Issues in Research and Policy Series (pp. 127-143). Springer. https://doi.org/10.1007/978-3-030-05858-6_9

Lonne, B., Higgins, D., Herrenkohl, T., & Scott, D. (2019). Reconstructing the workforce within public health protective systems: Improving resilience, retention, service responsiveness and outcomes. Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2019.104191

Lonne, B., Scott, D., Higgins, D., & Herrenkohl, T. (Eds.) (2019). Re-visioning public health approaches for protecting children. Child Maltreatment 9: Contemporary Re Issues in Research and Policy Series. Springer. https://doi.org/10.1007/978-3-030-05858-6

2018

Sanders, M. R., Higgins, D. J., & Prinz, R J. (2018). A population approach to the prevention of child maltreatment: Rationale and implications for research, policy, and practice. Family Matters, 100, 62-70. Available at: https://aifs.gov.au/publications/family-matters/issue-100/population-approach-prevention-child-maltreatment.

Further background reading on the public health approach to child protection

WHO guidelines on parenting interventions to prevent maltreatment and enhance parent-child relationships with children aged 0-17 years (2022). Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.

Herrenkohl, T. I., Leeb, R. T., & Higgins, D. J. (2016). The Public Health Model of Child Maltreatment Prevention [Introduction to the Special Issue of Trauma, Violence, & Abuse]. Trauma, Violence, & Abuse, 17(4), 363-365. doi: 10.1177/1524838016661034

Higgins, D. J. (2011). Protecting children: Evolving systems. Family Matters 89, 5-10. http://www.aifs.gov.au/institute/pubs/fm2011/fm89/index.html

Higgins, D. J. (2015). A public health approach to enhancing safe and supportive family environments for children. Family Matters, 96, 39-52. https://aifs.gov.au/publications/family-matters/issue-96/public-health-approach-enhancing-safe-and-supportive-family-environments-children

Higgins, D. (2014, July 29). Safe and Supportive Family Environments. CFCA Connect.https://aifs.gov.au/cfca/2014/07/29/safe-and-supportive-family-environments

Scott, D. A., Lonne, B., & Higgins, D. (2016). Public health models for preventing child maltreatment: Applications from the field of injury prevention. Trauma Violence & Abuse [Special Edition on Public Health Approaches to Child Maltreatment Prevention], 17(4), 408-419. https://doi.org/10.1177/1524838016658877

CFCA (2016). The public health approach to preventing child maltreatment. https://aifs.gov.au/cfca/2016/06/22/public-health-approach-preventing-child-maltreatment

Contact ICPS for further information