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Health Promotion Final Paper: Pediatric Neglect/Abuse

Ashley Altman 

Delaware Tech and Community College 

Nur330-601

Dr. J. Maloney

April 9, 2023
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Health Promotion Final Paper: Pediatric Neglect/Abuse

Every population has its needs for concern pertaining to the health and well-being of an

individual or group. There are two populations I believe that are most at risk for health problems

and at a huge need for priority health care, but my focus for this paper is solely on children. I am

going to be focusing on children in the state of Delaware and how they suffer from

neglect/abuse.

Review of the Data

Children of all ages, around the world suffer substantially from abuse and neglect.

Neglect is having the ability and financial means to care for a child, but the parent or caregiver

fails to provide necessary care, including food, shelter, or medical care; fails to provide

supervision appropriate for the child; or engages in substance abuse and the abuse negatively

impacts the care of the child (Child Advocate of Delaware, 2021). Abuse can be physical-

causing any physical injury to a child through unjustified force, torture, negligent treatment;

sexual- any act against a child that is described as sex offense in the Criminal Code, including:

sexual harassment, indecent exposure, incest, unlawful sexual contact, rape, sexual exploitation

of a child, or sexual abuse of a child by a person in a position of trust, authority or supervision;

and emotional- defined as psychological maltreatment (Child Advocate of Delaware, 2021).

Even the youngest of children, infants suffer from neglect, by being abandoned. In some

cases, parents leave their children in harm’s way or worse, death, by leaving their baby(ies) in an

unsafe location that they cannot be found or heard. Due to this incident occurring around the

world, each state has set up provisions on how to give their child up safely and confidentially

with no means of consequences by implementing the Safe Haven or Safe Surrender Laws. Each

state has its own regulations on age of child, the place, and personal of who can accept the infant
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(Guttmacher Institute, 2023). In Delaware, an infant may be relinquished up to 14 days old and

only health care personnel are allowed to receive the infant. The person leaving the baby can be

family or non-family and will remain anonymous, while the person accepting the infant must

provide an ID band, gather medical information, and investigate if infant is a missing child

(Guttmacher Institute, 2023). In Delaware, the Safe Arms for Babies was put in place to help

prevent abandonment of babies. Medical information is critical for the acceptor to receive about

the child and parent. An individual may surrender their baby unharmed to an employee or

volunteer at one the following designated safe havens: an emergency department of a hospital or

a police station (DelCode, n.d.).

Child abuse and neglect is problem in Delaware with

 18,240 total cases in 2020, of that only 4,845 were referred for investigation.

 1,200 child victims in Delaware, that is a rate of 5.9 of 1000 children who suffer from

abuse or neglect in 2020.

 Of the 1,200 children, 1,010 were first time victims.

 The largest age group of victims were children under the age of one, sitting at 140 of the

1,200 cases.

 67% of these abuse victims were perpetrated by their parents.

 With an outstanding number of 13 child related deaths from abuse/neglect in Delaware in

2019 and five in 2020 (CWLA, 2022).

Disparities and Barriers

Many children who suffered from abuse and/or neglect come from families of poverty or

foster care system. In 2020, Delaware had

 821 total children were served by the foster care system.

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 56,000 children lived with families that lacked secure employment.

 The state spent $6,559,210 on WIC in 2021, serving 17,199 people.

 114,190 children were food insecure in 2019, including 32,830 children who suffered

with hunger.

 43.7% of households were receiving SNAP benefits from the state of Delaware who had

children (CWLA, 2022).

Limitations to health insurance was another huge factor in the neglect of the children in

Delaware. In 2019,

 6.6% of Delaware children had absolutely no health insurance, while in 2020 34% were

uninsured.

In 2020,

 107,871 children were enrolled in Medicaid, that is 59%.

 13,573 were enrolled in the state’s Children Health Insurance Program (CHIP), that is

7%. Delaware spent $75,636,023 on child welfare services in 2018.

o $12,260,477 was allocated from the federal government.

o $62,276,637 came from local and state funding (CWLA,2022).

Another disparity is the rate in the Juvenile Justice System.

 2.924 total arrests in children under the age of 18 in Delaware in 2019.

o 224 were for disorderly conduct.

o 551 arrests for property crimes.

o 256 were for drug abuse violations.

 6% of the youth population, that is 3,000 children, were reported either not in-school or

working (CWLA, 2022).

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Substance abuse is a huge problem in these children due to the suffering of neglect/abuse.

In Delaware in the year 2017, between the ages of 12 to 17; around 1,000 children were alcohol

dependent and approximately 2,000 children were using illicit drugs and were not received

treatment causing Delaware to reach health care costs related to Opioid abuse to reach

109,439,642 (CWLA, 2019).

Due to the disparities and barriers of childhood abuse/neglect there are goals that need to

be formatted.

SMART Goal #1: Increase community education and awareness about child abuse and neglect,

including strategies for prevention, intervention, and treatment.

SMART Goal #2: Strengthen economic supports to families and change social norms to support

parents.

SMART Goal #3: Advocate for children and families and intervene to lessen harm and prevent

future risks.

Role of the Nurse

Due to these problems from the suffrage of abuse/neglect, Delaware has made it

mandatory to report any and all means of signs of child neglect and/or abuse. Delaware

law mandates any person, agency, organization or entity to make an immediate oral report to the

Department of Services for Children, Youth and Their Families, Division of Family Services,

when they know of, or suspect, child abuse or neglect under Chapter 9 of Title 16 of

the Delaware Code and to follow up with any requested written reports (16 Del. C. §903). The

officials that are required to file these mandatory reports include, but are not limited to:

physicians, nurses, persons in the health care, school employees, Medical Society of Delaware,

and law enforcement agencies (Delaware.gov, n.d.)

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The nursing profession can work with the community by providing community events to

help make these SMART GOALS achievable. Education and proper training can help make all

members of the community understand and knowledgeable on how to handle/ report abuse and

neglect. It is also very important for nurses to help encourage the community on how to support

one another and encourage each other to help prevent further or possible cases. One a community

comes together as a whole; everyone feels supported and lessens the chance of abuse/neglect.

Interventions and Resources

Resources are a must to help prevent and educate the community on child abuse and

neglect. In Delaware there are many resources that a community has at hand to help prevent

child abuse/neglect.

Resource #1: Delaware Division of Family Services. If you are concerned about a child's safety

or see signs of child abuse or neglect call the Child Abuse and Neglect Report Line at 1-800-

292-9582 or go to iseeethesigns.org

Resource #2: Child Mental Health Crisis Hotline. If a youth is experiencing a behavioral health

crisis, contact the Mobile Response Stabilization Services hotline at 1-800-969-4357 or text DE

to 741741.

Resource #3: Delaware Helpline. If you need help getting connected to a variety of community

resources, call 211.

Resource #4: Children’s Advocacy Center of Delaware.  Provide an array of child-focused

services in a safe, child-friendly setting.

Resource #5: Children and Families First. Provide the supports and services children and their

families need to thrive.

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Resource #6: Prevent Child Abuse Delaware. Mission is to provide resources and training to

make certain that every child in Delaware has a safe and nurturing childhood, free from abuse

and neglect. (Delaware Courts, n.d.)

Health Promotion Plan

To achieve a decrease in child abuse and neglect, as a community we must follow the

SMART goals and use our resources to help prevent future harm. As nurses and a member of a

community, it is our job to seek out and report and save these children from any harm they may

be facing, by following these interventions.

Intervention #1: Distribute resource information and educational material.

Intervention #2: Regularly provide community programs and informational sources.

Intervention #3: Provide community training related to child abuse/neglect and prevention.

Intervention #4: Promote Child Abuse Prevention Awareness Month in April.

Intervention #5: Enhance parenting skills and family relationship approaches.

Intervention #6: Enhance seeking health care needs/ care.

Evaluation

Child abuse and neglect is a problem world-wide and needs to be monitor and

reported immediately. Each of these SMART goals and interventions need to be implemented in

communities in vastly quick timeframe. More education needs to be done in every community

and I believe local and state governments need to help implement these goals over a years’ time

frame. These children deserve a full opportunity at a safe, healthy life. It is everyone’s

responsibility to speak up and protect our children of the world!

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Resources

CWLA. (2019). Delaware’s Children at a Glance. Delaware’s Children 2019. Delaware-

2019.pdf (cwla.org)

CWLA. (2022). Delaware’s Children 2022. Delaware-Fact-Sheet-2022.pdf (cwla.org)

Child Advocate of Delaware. (2021). Mandatory Reporting of Child Abuse and Neglect

Resource Guide. Mandated Reporter Resource Guide.pdf (delaware.gov)

Delaware Courts. (n.d.). Child Abuse Prevention Month. Child Abuse Prevention Month - Office of

the Child Advocate - Delaware Courts - State of Delaware

Delaware.gov (n.d.). Mandatory Reports Related to Child Abuse and Neglect. Mandatory

Reports Related to Child Abuse and Neglect - Division of Professional Regulation - State

of Delaware

Delcode. (n.d.). Regulatory Provisions Concerning Public Health. Title 16. Chapter 9. Abuse of

Children. Delaware Code Online

Guttmacher Institute. (2023). Infant Abandonment. Infant Abandonment | Guttmacher Institute