Applying a public health approach: the role of state health departments in preventing maltreatment and fatalities of children.

Child maltreatment prevention is traditionally conceptualized as a social services and criminal justice issue. Although these responses are critical and important, alone they are insufficient to prevent the problem. A public health approach is essential to realizing the prevention of child abuse and neglect. This paper discusses the public health model and social-ecology framework as ways to understand and address child maltreatment prevention and discusses the critical role health departments can have in preventing abuse and neglect. Information from an environmental scan of state public health departments is provided to increase understanding of the context in which state public health departments operate. Finally, an example from North Carolina provides a practical look at one state's effort to create a cross-sector system of prevention that promotes safe, stable, and nurturing relationships and environments for children and families.

Dialing for help: state telephone hotlines as vital resources for parents of young children.

Toll-free telephone hotlines operated by the states are increasingly being used by families to obtain reliable advice on their young children's health and well-being. Originally created for prenatal-care assistance alone, these lines now cover a wide range of early-childhood issues. But while the majority of the lines deliver high-quality information, promptly and empathetically, to their callers, there is still considerable room for improvement. For example, greater use could be made of experts in early-childhood services, and of knowledgeable parents, for speaking with callers and training other staff. The lines could also be made more easily accessible in several ways: through the national 800 number for childhood issues, via the more general 2-1-1 number for community-based services, and by means of a Web site for each line so that it could serve its audience at virtually any time of the day or night.