Remarks as prepared; not a transcript

Vice Admiral Richard H. Carmona, M.D., M.P.H, FACS
United States Surgeon General
U.S. Department of Health and Human Services

Launch of Child Abuse and Neglect Prevention Month

Safe Shores Child Advocacy Center, Washington, D.C.
Thursday, April 1, 2004


"Stopping the Heartbreaking Cycle of Child Maltreatment:
Improving Prevention and Protection"

Thank you, Dr. Horn (Wade Horn, Ph.D., Assistant Secretary for Children and Families). And thanks for your great leadership at ACF, where important work to prevent child abuse takes place.

While most American children grow up healthy and happy, some are deeply wounded by emotional and physical mistreatment. And while child maltreatment has traditionally been thought of as a criminal justice issue, it is also very much a public health issue.

Iíve seen it from both sides, as a law enforcement officer, and as a trauma surgeon. From the law enforcement side we emphasize protection, from the public health side we need to emphasize prevention.

In 2002, 1,400 children died from abuse or neglect. And nearly 900,000 children were abused. Although fewer children are being abused now than ten years ago, any violence against our children is too much.

That this type of abuse can occur in the closest of relationships makes it extremely difficult to understand.

There is the added pain of betrayal. It is natural for a child to expect love and caring from his parents and caregivers, but when that love is tarnished from abuse and neglect, the scars cut right through the body to the spirit.

Some of you donít have to imagine the emotional and physical devastation that occurs when someone you love, and who is supposed to take care of you, hits you, shakes you, locks you in a closet, doesnít feed you, or worse.

Child victims are often afraid to tell anyone that they are being hurt at home. The reality is that as a society we are still too reluctant to discuss child abuse and maltreatment.

Too often, child abuse is hidden behind a wall of secrecy, silence, and shame.

The individual and societal consequences of child maltreatment can be severe:

  • Physical injury or death
  • Chronic health conditions
  • Broken families, and emotional devastation
  • Increased health care expenditures
  • It is a problem within American families that can torture any race, ethnicity, or socio-economic group.

    The wrenching mental and physical health effects of child maltreatment continue for that child long after he or she is placed in a safe environment. There is a lasting cycle of violence and pain. The child who is abused becomes the teenager who is violent toward his peers, and then the man who is violent toward his wife and children. Or a child victim may grow up and again be victimized in adult relationships.

    This administration has great concern for the victims of child abuse and neglect.

    President Bush, HHS Secretary Tommy Thompson, and Dr. Christina Beato, the Acting Assistant Secretary for Health, are leading the way in child abuse prevention policies.

    Dr. Beato is tasked with the important job of leading President Bushís "Safe and Bright Futures for Children Initiative," an effort focused on children who witness or are victimized by domestic violence.

    This initiative seeks to prevent the immediate and long-term consequences and break the cycle of violence.

    Certainly we can and must do more on the prevention side. Promoting healthy lifestyles for families can help, and one of our Departmentís top priorities is disease and injury prevention.

    We can no longer ignore the painful cries of the victims.

    The fact that children in America still suffer and die at the hands of abusers compels us to be aggressive in developing ways to prevent abuse from occurring and stop it early if it does occur.

    That is why I am going to convene some of the best minds in criminal justice, medicine, child welfare and education in a Surgeon General's Workshop on Child Maltreatment, to help shine a bright light on this problem and help determine next steps to end this scourge on our society.

    Thank you.

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    Last revised: January 9, 2007