Category Archives: Violence Prevention
Antoinette L. Laskey, MD, MPH, FAAP, is an associate professor of pediatrics and division chief and medical director at the Center for Safe and Healthy Families at the Primary Children’s Medical Center at the University of Utah in Salt Lake City. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program (2001-2003).
During medical school at the University of Missouri-Columbia, I had my first exposure to child abuse pediatrics. As a third-year student on my pediatrics clerkship, I had the opportunity to participate in the care of a child whom I suspected had been beaten. From that point forward I knew this was where I wanted to spend my career.
I started looking into fellowship opportunities even before I had started my residency. Early in my intern year in 1998, I reached out to Des Runyan, MD, DrPH, a pioneer in child abuse pediatrics and an alumnus of the RWJF Clinical Scholars program (1979-1981) who was then at University of North Carolina at Chapel Hill and who is now national program director of the RWJF Clinical Scholars program. We arranged a visit so that I could learn more about the field through his expert eyes.
Before child abuse pediatrics was recognized as an official subspecialty of pediatrics, there were two different paths to enter practice: a one-year “apprenticeship” or a two-year clinical and research fellowship. In my short visit to Chapel Hill, it became apparent to me that an RWJF Clinical Scholars position was the way I needed to go to not only practice in the field of child abuse pediatrics but to also gain the knowledge base necessary to move the field forward.
Andrea Gottsegen Asnes, MD, MSW, is an assistant professor of pediatrics at the Yale School of Medicine and a Robert Wood Johnson Foundation (RWJF) Clinical Scholars program alumnus (2001-2003).
Human Capital Blog: What kind of work do you do in the area of child abuse pediatrics?
Andrea Gottsegen Asnes: I am a child abuse pediatrician. Nearly eight years ago, I joined former Robert Wood Johnson Foundation (RWJF) Clinical Scholar and fellow child abuse pediatrician John Leventhal, MD, as a member of the faculty of the Yale School of Medicine. In 2009, we both became board certified in the new pediatric sub-board of child abuse pediatrics. At Yale, I am the associate director of the Yale Child Abuse and the Yale Child Abuse Prevention programs.
Most often, I am asked to evaluate suspected cases of child abuse by other medical colleagues, by my state’s child protective services agency, or by local police departments. I am frequently asked to testify in court as a medical expert in cases of suspected child maltreatment. I also participate in several multidisciplinary, community-based teams that are designed to improve both criminal prosecutions of those who abuse children as well as the care that abused children receive.
I have a particular interest in optimizing recognition of subtle signs of physical abuse by frontline pediatric providers, and I teach on this subject regularly. I also have a special interest in linking abused children and their non-offending caregivers to mental health treatment. In 2006, I started the Bridging Program, which provides immediate, evidence-based mental health care to sexually abused children and their non-offending family members. My hope for the future is to devote increasingly more time to work in child abuse treatment and prevention.
Brendan T. Campbell, MD, MPH, is an assistant professor of surgery and pediatrics at the University of Connecticut School of Medicine and an alumnus of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program (2000-2002).
Human Capital Blog: What kind of work do you do in the area of child abuse pediatrics?
Brendan Campbell: I am a pediatric general and thoracic surgeon and the medical director of the pediatric trauma program at Connecticut Children’s Medical Center in Hartford. Connecticut Children’s is a Level I pediatric trauma center, which means we see patients with relatively minor and severe multisystem injuries. Caring for abused children is one of the most important services we provide. When children with non-accidental trauma are initially identified, they are admitted to the pediatric surgical service to rule out life-threatening injuries. During their admission we work closely and collaboratively with the suspected child abuse and neglect team (SCAN) to make sure children with inflicted injuries are identified, have their injuries treated, and are kept out of harm’s way.
HCB: Why did you decide to focus on this area?
Campbell: It can be challenging to get a pediatric surgeon interested in child abuse because caring for vulnerable children who are intentionally harmed is not easy, and most of these kids don’t have life-threatening injuries that require an operation. What draws me to the care of injured children is that they are the patients who need me the most. If we don’t identify the risks they are up against at home, no one else will. They need someone to advocate for them.
The other thing that draws me to child abuse pediatrics is that there is an enormous need to develop better ways to screen for and to prevent abuse. Over the last 30 years we’ve made enormous strides in lowering the number of children injured in car crashes by enacting seat belt laws, toughening drunk-driving laws, and improving graduated driver licensing systems. Child abuse in the United States, however, remains a significant public health problem that needs more effective screening initiatives and prevention programs.
By Elizabeth A. Kostas-Polston, PhD, ARNP, WHNP-BC, Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar and assistant professor, University of South Florida; and Versie Johnson-Mallard, PhD, MSMS, ARNP, WHNP-BC, RWJF Nurse Faculty Scholar alumna and assistant professor, University of South Florida.
On November 14, 2012, we met a princess. No, we were not at Disneyworld or Disneyland. The princess was beautiful, talented and focused on making a difference in her country for girls and women. The princess’s name is Princess Bajrakitiyabha Mahidol, her Royal Highness of Thailand. We met her when we were invited to Thailand to present at the International Council on Women’s Health Issues (ICOWHI) 19th International Congress on Women’s Health 2012: Partnering for a Brighter Global Future.
During the conference we unveiled our national/international initiative, The Blue Bra Campaign: Leading Global Change in Women’s Health. The Blue Bra Campaign is housed at the University of South Florida College of Nursing, under our leadership. The name for the campaign was inspired from an international event that occurred in 2011, when a young Egyptian woman was beaten, stomped on and nearly stripped while participating in a political demonstration. Aside from the sheer brutality inflicted upon her by Egyptian police, what stood out to millions viewing the nightmare as it unfolded on international television was the young woman’s abaya falling open to reveal a lacey, bright-blue bra. That moment was so unexpected, so shocking—so transforming! The young woman, covered from head to toe in traditional dress, refused to remain invisible demonstrating her femininity through her choice of undergarment—a blue bra!
Jason Corburn, PhD, MCP, is associate professor at the School Public Health & Department of City & Regional Planning, University of California, Berkeley. He is a recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and an RWJF Health & Society Scholar. This post is part of the "Health Care in 2013" series.
The U.S. health care system must stop treating people only to send them back into the living, working and playing conditions that are making them sick in the first place. Glaring health inequities continue to persist in our metropolitan areas – differences in life expectancy, disease and disability by racial and ethnic groups and neighborhood location. Our zip codes are often a greater predictor of our likelihood of disease, disability and early death than our genetic code. We need to shift our health care system from a focus largely on cures to preventing illness and death by improving our living, working and playing environments.
2013 must be the year we all view community development and city planning as ‘preventative medicine.’
E. Alison Holman, PhD, FNP, is an assistant professor in nursing science at the University of California, Irvine and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar. She has received the Chaim Danieli Young Investigator’s Award from the International Society for Traumatic Stress Studies for her research on early cognitive predictors of long-term adjustment following trauma. She studies how people cope with highly stressful experiences with special interest in understanding how trauma affects long-term mental and physical health.
The tragedy in Newtown CT violated everything we hold dear, with 20 innocent children among the carnage. My heart aches for Newtown, the families who lost their children, the children who lost their siblings and friends. It is so sad.
According to FBI records, on average, 27 Americans were murdered with firearms every day in 2011. Yet, last Friday, White House spokesman Jay Carney said "today is not the day for a debate on gun control." But if not now, when? On April 28, 1996, 35 people were murdered in Port Arthur, Tasmania by a gunman from New Town, Australia. Within 12 days the Australian government adopted bipartisan gun control legislation. In the 15 years since these new gun control laws were passed, no mass shootings have occurred in Australia. Do we have the resolve to do the same here?
Manish K. Sethi, MD, is a health policy associate at the Robert Wood Johnson Foundation (RWJF) Center for Health Policy at Meharry Medical College and a Pilot Project Mini-Grant recipient and renowned orthopaedic trauma surgeon at Vanderbilt University’s Orthopaedic Institute Center for Health Policy. Sethi spoke this morning during the 2012-2013 Grand Rounds Series, sponsored by Meharry Medical College School of Medicine, on “Gun Violence in Nashville: Working Towards Community Based Solutions.”
Human Capital Blog: What is the violence prevention program you’re directing with the RWJF Center for Health Policy at Meharry?
Sethi: We are doing a youth violence intervention program via partnership with Nashville schools funded by the RWJF Center for Health Policy at Meharry.
All of the data demonstrates that educational intervention with this age group demonstrates positive results. Currently, no such program exists in Nashville schools.
HCB: What drove your interest in this topic?
Sethi: I am a trauma surgeon and have been seeing an inordinate number of gun violence injuries in African American teenagers. I grew up in Tennessee and left for my medical training, but during childhood I never saw violence to this degree. Almost every week I see a teenager who either loses his life, or suffers major trauma secondary to a gun violence injury. I care very deeply about the future of these children and of Tennessee and I just feel that we have to do something.
Ten individuals who have overcome significant challenges to help improve health and health care in their communities will be named 2012 Robert Wood Johnson Foundation (RWJF) Community Health Leaders at an awards ceremony in San Antonio.
These remarkable individuals are providing vital health services to residents in their communities, from Anchorage, Alaska to Charleston, South Carolina, and in cities and towns in between. They are helping: refugees grappling with the after-effects of war; low-income workers without insurance; children facing obesity; survivors of sexual violence; senior citizens who live in remote, rural areas; and substance abusers at risk for overdose.
The 2012 Community Health Leaders Award recipients are:
- Kay Branch, MA, elder/rural health program coordinator, Alaska Native Tribal Health Consortium, Anchorage, Alaska;
- Fred Brason, CEO of Project Lazarus and Project Director of the Community Care Network Statewide Chronic Pain Initiative, Wilkes County, N.C.;
- Debbie Chatman Bryant, DNP, RN; assistant director for cancer prevention, control, and outreach, Hollings Cancer Center at the Medical University of South Carolina, Charleston, S.C.;
- Beth Farmer, MSW, international counseling and community services program director, Pathways to Wellness Project, Lutheran Community Services Northwest, Seattle;
- Amy Johnson, JD, executive director, Arkansas Access to Justice Commission, Little Rock, Ark.;
- Ifeanyi Anne Nwabukwu, RN, BSN, chief executive officer, African Women’s Cancer Awareness Association (AWCAA), Silver Spring, Md.;
- Cristina Perez, MA, director of community outreach and counselor, Women Organized Against Rape, Philadelphia;
- Marlom Portillo, executive director, Instituto de Educacion Popular del Sur de California (IDEPSCA), Los Angeles;
- Darleen Reveille, RN, senior public health nurse, Garfield, N.J.; and
- Kathi Toepel, director of senior services for the Mother Lode Office of Catholic Charities – Diocese of Stockton, Sonora, Calif.
By Jooyoung Lee, PhD, assistant professor of sociology at the University of Toronto and a 2009 – 2011 Robert Wood Johnson Foundation Health & Society Scholar at the University of Pennsylvania
Ervin is a black Rastafarian. He has a calm and easy-going demeanor, something that he attributes to growing up in a small Jamaican village near Kingston. On most days, Ervin rolls his long set of locks into a beehive that he conceals beneath brightly colored turbans.
He was one of the first gunshot victims that I met while conducting ethnographic research in Philadelphia. On a chilly Friday in January, Ervin hobbled into the trauma clinic at The University of Pennsylvania. His work boots were covered with tufts of snow and his puffy winter jacket hid a lean and muscular 35-year old body.
When I first introduced myself and the purpose of my study, Ervin smiled from ear-to-ear. He was anxious to tell his story and gave me a detailed play-by-play of how he had been shot twice in the legs—both 9mm bullets had been retained and were causing him great discomfort and pain.
Although he was nearly a year removed from his shooting, Ervin spoke openly about recurrent nightmares, trouble sleeping at night, and described feeling frightened by loud noises in his neighborhood—some of which were “false alarms” and others which were gunshots fired near his home. Although I am a sociologist by training and have never been trained in counseling or psychotherapy, my gut told me that Ervin was suffering from post-traumatic stress symptoms.
A couple weeks later, I visited Ervin at his home. During my visit, I asked Ervin if he had ever spoken to a mental health professional about his trauma. He shook his head and explained that he knew of free mental health services in Philadelphia, but could not afford to go. As a day laborer, Ervin relied on landscaping, construction, and other manual labor that often required him to be ready for work at a moment’s notice. He explained, “If they call me and I’m at some office, I might lose a job that could be the only one I get for a few weeks.”
How a Personal Experience Led to a Program of Research Focused on Eliminating Intimate Partner Violence Disparities Among Hispanic Women
The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week. It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority. The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week. This post is by Rosa M. Gonzalez-Guarda, PhD, MPH, RN, Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar and Assistant Professor, University of Miami, School of Nursing & Health Studies.
As a young Cuban-American and Miami native who grew up in an Hispanic enclave, I was naturally drawn to Hispanic men—short, dark and handsome. Who would have expected that I would have found him during my last year of college at Georgetown University in Washington, DC? I fell in love with this other Cuban-American Miami native quickly. He was fun, smart, charming, had strong family values and, to top it all off, he could dance salsa and merengue.
It was not too long before I realized that my college sweetheart was jealous and controlling. However, this did not seem all that unusual since these are characteristics that are endorsed by many in the culture where I come from. In fact, when I questioned that he was “allowed” to go out with his friends to bars, but I was not, some family and friends agreed with him. Although I did not realize it at the time, the “allowed” language and his controlling behavior were a good indicator of what lay ahead in our relationship—a nightmare.
Moments of romance and bliss turned into moments of anger, aggression and torment. Times of peace grew shorter and shorter, as he grew increasingly emotionally abusive. He did some “man handling” too.
When I decided to go off to graduate school at Johns Hopkins University School of Nursing and the Bloomberg School of Public Health, things got worse. I was in another city and the co-chair of a social and cultural student committee. This made him feel like he was completely out of control and very jealous. He grew more aggressive and emotionally abusive. My family and friends became increasingly worried about me, as they saw my cheery personality slowly dwindle. My parents put a lot of pressure on me to break things off. I knew they were right, but for some reason I couldn’t bring myself to do it. I just needed time.
I thought that I could appease my family by getting help. I went to the school psychologist and when a faculty member at the School of Nursing looked for volunteers for a research study on teen dating violence, I quickly signed up. At that time, I had no idea that the Principal Investigator of the study was a world renowned violence researcher: who else but our very own Jacquelyn Campbell, PhD, RN, FAAN, who directs the RWJF Nurse Faculty Scholars program. Working on this study made me realize that I also wanted to conduct research on health disparities affecting my own community of Hispanic women at home. As I fell in love with the prospects of health disparities and violence research, I fell out of love with an abusive partner.