Posted: November 21, 2019
By: Lance Goller M.P.A., Research Administrator at MAHEC, Asheville, Bernstein Fellow Graduate 2017-2019

In 2017 I began the Bernstein Community Health Leadership Fellowship, a program of the Foundation for Health Leadership an Innovation, while working at a Federally Qualified Health Center. Shortly after I began my fellowship, I unexpectedly changed jobs and shifted to working at an organization that focused on early childhood, tasked with using a Collective Impact model to improve the health and well-being of young children in a rural county in Western North Carolina.

Initially this task seemed daunting. I had never worked in early childhood before. I was funded through a time-limited grant that had less than a year to go, so I had to develop ideas and projects rather quickly.

I used a 2-prong approach to help determine priorities.

First, I met with community members and staff from agencies who were already working to improve the lives of young children in the county, following the concept of “100 cups of coffee”, to learn what they thought could be done to help young children.

Next, I reviewed as much data as I could find that would provide further insight on the state of young children in the county. Issues that arose out of conversations mostly centered on the lack of affordable childcare and consequent economic challenges facing families with young children.

Looking at health and other data, the county was among the healthiest in the state. However, digging further into publicly available datasets, I was surprised to find that the rates of child abuse were about double the statewide average, and among the highest in any county in Western North Carolina. As I shared the child abuse data with people I met with, most were not aware that this was a problem in our community.

Working on this issue became my fellowship project.

Around this time, at a statewide Smart Start conference, I met staff from Prevent Child Abuse NC (PCANC), who presented on their Community Prevention Action Plan which aimed reduce child abuse in an Eastern NC county. I asked PCANC to consider helping my community develop our own plan to reduce child abuse, and they agreed.

The process began with a Community Café, where we shared the latest child abuse data with over 60 attendees, including staff from the Departments of Health and Social Services. Most of the reported child abuse was categorized as neglect, with a quarter of all cases specifically mentioning substance use as a key factor. Many were surprised by the high rates of child abuse in our county and were spurred to action.

To develop a local child abuse prevention plan, PCANC requires that interested community members get trained in the Protective Factors framework, to provide a practical foundation to develop the plan.

PCANC subsequently traveled to our county and trained about 40 stakeholders interested in reducing child abuse in our community.

To build the plan, we will consider how factors – such as social determinants of health, the opioid epidemic, and community support for parents – impact our community in negative or positive ways.

A local steering committee was formed to meet monthly to discuss the issue moving forward. In October 2019, PCANC began working with the committee to begin building the Community Prevention Action Plan.

But the success of the building and implementation of this plan depends on the investment and engagement of community members and agencies working on this issue.

I have no doubt that by working together as a community, we will reduce the rates of child abuse and improve the lives of many children.