Lessons From History: Parents Anonymous and Child Abuse Prevention Policy.

Abstract

* Abbreviation: CAPTA — : Child Abuse Prevention and Treatment Act Child abuse policy has long been a politically contentious topic in the United States. This article points to a critical moment in the mid-1970s in which a small organization, Parents Anonymous, helped shape a paradigm for understanding child abuse and its causes. This approach would remain influential for decades despite contradictory evidence. Although researchers in numerous studies from the 1960s and onward have suggested that racial and social inequality contribute significantly to serious child injury,1–3 the advocacy work of Parents Anonymous was instrumental in drawing the discussion away from social determinants of health. This article examines the historical origins of the perception of child abuse as being an equal-opportunity social ill related solely to parental mental health rather than to socioeconomic inequities. It uses this historical background to suggest the need for a discussion of the role of social inequities as being at the crux of child abuse prevention. In early 1973, Minnesota Senator Walter Mondale developed legislation to authorize funds for child abuse prevention and treatment. This would become the Child Abuse Prevention and Treatment Act (CAPTA) signed by President Richard Nixon in early 1974, and it has enjoyed decades of bipartisan support. One of the reasons for CAPTA’s popularity was that it intentionally circumvented discussions of race and class despite available evidence indicating the importance of these social factors.4 Although then-contemporary research had found that child abuse was more common in low-income families, Mondale actively pushed an agenda presenting child abuse as a scourge of all walks of society. This is evident in the bill’s 1973 hearings. When renowned child abuse researcher David Gil testified on the higher incidence of child abuse in poor and minority families, Mondale pushed back, leading Gil to concede that child abuse indeed also happened in middle-class families. Mondale … Address correspondence to Mical Raz, MD, PhD, 1310 Blockley Hall, 423 Guardian Dr, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104. E-mail: micalraz{at}mail.pennmedicine.upenn.edu