Citation

Jäderholm CM, Williams T. JAMA Netw. Open 2024; 7(7): e2420524.

Copyright

(Copyright © 2024, American Medical Association)

DOI

10.1001/jamanetworkopen.2024.20524

PMID

38976272

Abstract

The evidence and recommendations from the United States Preventive Service Task Force (USPSTF)1 are timely and valuable as primary care continues to grapple with interventions aimed at preventing child maltreatment and its negative health consequences. In their review of evidence,1 the USPSTF found insufficient evidence to recommend specific screening or intervention services in primary care settings. Therefore, they recommend generating evidence for interventions outside of clinic settings to prevent child maltreatment in future efforts.

Another aim of the USPSTF was to address racism and bias within reporting systems to make equitable recommendations around prevention efforts.1 Historically, child welfare systems have separated marginalized families (eg, poor, Black, and Indigenous families) at a higher rate than well-off and White families. Therefore, the effort to understand reporting biases is imperative. Still, for accurate equity to prevail in child maltreatment prevention, efforts outside the clinic--in communities and through family support and policy--may be the best approach.

The USPSTF recommendations1 open opportunities to consider community-level disparities and the policies that uphold them as drivers of child maltreatment.2 Hence, community-based family support and policies supporting families should be regarded as potential preventative mechanisms. However, for community-based and policy interventions to be a mechanism for equity, they must center and support marginalized communities and families. We expand on a recommendations made by Hart et al,2 including access to mental health and substance use treatment, by focusing on a specific window of opportunity: supporting marginalized pregnant and postpartum people with substance use disorder (SUD) to prevent child maltreatment and move toward health equity for children and their families. ...

Language: en

Keywords

Humans; Child; Infant; Infant, Newborn; Female; Pregnancy; *Child Abuse/prevention & control; *Substance-Related Disorders/prevention & control; Pregnancy Complications/prevention & control