Investing in Prevention
Countless studies have demonstrated that prevention is worth every penny. Research suggests that for every dollar spent on early childhood prevention programs, we save between $4 and $7. Investing in prevention translates to fewer dollars spent on foster care, welfare, juvenile justice and a host of other programs further down the road.
When it comes to child abuse, we’re clearly talking about more than just dollars and cents. Abuse has detrimental and lasting consequences for a developing child. Effective prevention programs that foster child well-being and promote the security and stability of families hold promise – improving parent-child relationships, reducing likelihood for abuse, promoting child well-being, and lessening the current financial strain on our child welfare system.
In order to reduce the number of children entering foster care, we must substantially increase our investment in prevention efforts, including prenatal care for pregnant women, supports, training and education for new parents, and substance abuse treatment for high-risk parents. Providing supports and services for at-risk families is critical to ensuring that they never enter the child welfare system in the first place.
Promising Prevention Efforts
The following are three promising prevention efforts we believe deserve a greater share of our federal investment:
- Investing in a Healthy Start. Healthy Start is an effective intervention designed to reduce infant mortality and improve early childhood outcomes in communities plagued by high rates of infant mortality. Healthy Start projects have been successful at reducing infant mortality and low birth weight, improving prenatal care, and reducing barriers to health care for pregnant women and newborns. And because every Healthy Start site develops a consortium of neighborhood residents, parents, medical providers, social service agencies, faith representatives and business leaders, Healthy Start engages the whole community in helping children to survive and succeed. Healthy Start is a sound investment in families – one we believe is critical to ensuring that our children have a bright future.
- Investing in Nurse Home Visitation Programs. Nurse home visitation programs are an effective tool for promoting healthy parent-child relationships. Data indicate that participation in the program leads to significant improvements across a range of maternal, child and family outcomes. In fact, participation is associated with reduced prenatal smoking, fewer injury-related healthcare visits for children, fewer unintended subsequent pregnancies and longer delay between first and second births, as well as increases in children’s school readiness and decreased use of welfare and food stamps. We believe that investing in nurse home visitation programs is critical to ensuring healthy parent-child relationships in high-risk families.
- Ensuring Access to Substance Abuse Treatment for Parents. According to SAMHSA, 6 million children under the age of 18 live with a drug or alcohol dependent parent. Moreover, the majority of women (69%) and men (53%) entering treatment for substance abuse report having a child. It should come as no surprise then that in over 50% of all child welfare cases, parental substance use is a major factor - and in some parts of the country, the rate may be as high as 80%. Yet access to treatment remains a barrier for many struggling parents. In a recent survey, states reported - as their top concern - dissatisfaction with (lack of) mental health and substance abuse services for parents in at-risk families in the child welfare system.
Given the pervasiveness of the problem in the child welfare population - it is essential to invest in comprehensive and effective substance abuse treatment for high-risk families. Family-based treatment is one such effective and affordable intervention for substance abusing parents and their children. In fact, a 2003 SAMHSA evaluation of the programs found significant reductions in substance use and relapse – more than 60% of women remained sober 6 months after discharge. These numbers are especially encouraging given that a large majority of women who entered the program were chronic substance users who had attempted, unsuccessfully in the past, to cure their addictions.
The program evaluation yielded other promising findings. For instance, rates of arrest post-treatment dropped dramatically and women were also more likely to be employed after treatment. Although almost half of participating women reported having a child removed from their custody by Child Protective Services (CPS) at some point in time - and had at least one child in foster care at treatment initiation - the evaluation found significant reductions in the number of women who reported having a child in foster care post-treatment. In addition, rates of premature delivery, low birth weight, and infant mortality were also improved for participating women. We believe it is essential to continue to provide funding for family-based treatment, to ensure that parents have access to effective and comprehensive treatment for substance abuse.
