Child Abuse Prevention

* Thank you for printing such an excellent article, “Parents Get an Ounce of Prevention” (Aug. 17), on Hawaii’s home visitation program designed to prevent child abuse. Lately, so much of our attention has been focused on the sick, actual cases that occur, or on the histories of those abused children now grown who are incarcerated or severely disturbed as a result of that abuse, that it is hard to realize this problem, in many cases, can be prevented.

What was not mentioned in your article is that Los Angeles County has, on a very small, limited scale, a program that has for years been directly involved in the prevention of child abuse and neglect. It is called Public Health Nursing, and is a component of the Department of Health. Public health nurses (PHNs) have been intimately involved in the lives of many families nationwide since the early 1900s.

In Los Angeles County, the PHNs are primarily persons responsible for going to patient homes to follow up on cases of infectious diseases, to help prevent their spread into the community. From a program called Baby Tracking that exists in some of our county hospitals, PHNs are given the names of newborns delivered that do not have identified health care resources. The PHN contacts the families and helps the family access an affordable health care resource for immunizations and routine well-child care. As a PHN who has done many of these baby-tracking visits, I can sadly say that it was not uncommon to find situations that could potentially lead to child abuse. As a result, instead of just referring the child for health care services, I often became involved in educating and counseling families, referring them to support agencies.

Although no statistical studies were done, I am sure that L.A. County PHNs prevent many cases of child abuse daily. Unfortunately, due to continued budget cutbacks in the Department of Health, the number of PHNs has dwindled to about 260 to serve a county of more than 9 million. Needless to say, much of the PHN work tends to focus on high priority items, such as infectious disease prevention, leaving little time to work directly with families and children.

Nurses are ideal for prevention programs as they are well received by families who view them as “helpers” and not “government agents.”

JEANNE D. SMART

L.A. County Dept. of Health Services