Idea Gallery is a recurring editorial series on NewPublicHealth in which guest authors provide their perspective on issues affecting public health. In this Idea Gallery, Bryan Samuels, Commissioner of the Administration on Children, Youth and Families, provides his perspective on how communities and organizations and families can work together to keep children safe, in honor of Child Abuse Prevention Month.

Throughout the month of April, we turn our attention to the prevention of child abuse and neglect, celebrating those efforts in neighborhoods, faith communities, and schools that keep children safe and help families thrive. Whether formal or informal, these efforts involve wrapping caregivers and children in supports that reduce risk factors for maltreatment and promote protective factors, by decreasing stress, boosting parenting skills, and helping parents manage substance abuse or mental health issues.

Last year, more than 675,000 U.S. children were victims of maltreatment. These children are more likely than their peers to have emotional and behavioral problems, struggles in school, and difficulty forming and maintaining relationships. The effects of abuse and neglect can be pernicious and lifelong.

In recent years, we’ve come a long way in learning what it takes to help children who have experienced abuse and neglect heal and recover. We have interventions that help put families back together after maltreatment has occurred. But preventing abuse and neglect in the first place by giving families the support they need, when they need it, yields the best outcomes.

Small Amounts of Daily Exercise Can Help Teens Quit Smoking
As little as 30 minutes of daily exercise can help kids quit smoking, according to a new study in the Journal of Adolescent Health. It can also help to reduce tobacco use. Researchers found that daily smokers were more likely to reduce or quit smoking if they combined a fitness program with a smoking cessation program, rather than just a cessation program alone. Every teen in the study smoked an average of half a pack of cigarettes each weekday and a full pack a day on weekends. And that was just one of the poor health habits of many of the participants. "It is not unusual for teenage smokers to engage in other unhealthy habits,” said author Kimberly Horn, associate dean for research at the George Washington University School of Public Health and Health Services. “Smoking and physical inactivity, for instance, often go hand in hand.” According to the U.S. Centers for Disease Control and Prevention, about 13 percent of Americans age 18 and under smoke tobacco. Read more on tobacco.

Study: Low Food Security, Exposure to Violence Closely Linked
There is a close correlation between low food security and exposure to violence, according to a new study in Public Health Nutrition. Researchers spoke with forty-four mothers of children age 3 and under who participated in public assistance programs, finding increased exposure to violence, which in turn increased the chance of negative mental health, an inability to continue school and an inability to make a living wage.  The violence included child abuse, neglect and rape. The study clearly demonstrates the need to consider and include violence prevention efforts when establishing policies to deal with hunger. Read more on violence.

Size of Parents’ Social Groups Can Affect Whether Kids are Vaccinated
What they hear from friends and the people in their social group may affect whether parents have their children vaccinated, according to a new study in the journal Pediatrics. Parents who were less likely to vaccinate were also more likely to have large social groups and rely on books, pamphlets and the Internet for information on vaccines. "I think that what needs to be done is that everybody needs to understand the importance of vaccines,” said Joseph Anthony Bocchini, Jr., MD, chairman of Pediatrics Medicine at Louisiana State University Health Sciences Center in Shreveport. “And they're not only important for the people who receive them but they're also important for the community." About 95 percent of kindergarten-aged children are appropriately vaccinated, according to the U.S. Centers for Disease Control and Prevention. Read more on vaccines.

Media Coverage of Mass Shootings Harms Attitudes on Mental Illness
Media coverage of mass shootings by people with mental illness can increase support for policies to reduce gun violence, but can also increase the stigmatization of people with mental illness and lessens the chance they will seek help, according to a new study in the American Journal of Psychiatry. “The aftermath of mass shootings is often viewed as a window of opportunity to garner support for policies to reduce gun violence, and this study finds public support for such policies increases after reading news stories about a mass shooting,” said study author Emma E. McGinty, MS, a PhD candidate with the Johns Hopkins Center for Gun Policy and Research, part of the Johns Hopkins Bloomberg School of Public Health. “However, we also found that the public’s negative attitudes toward persons with serious mental illness are exacerbated by news media accounts of mass shootings involving a shooter with mental illness.” Read more on violence.

Study Links Excessive Television Viewing, Antisocial Behavior in Young Children
Antisocial behavior is more likely in young children who watch three or more hours of television a day, according to a new study in the Archives of Disease in Childhood. Researchers found that five-year-olds in that demographic were more likely to exhibit such behavior by the age of seven. Study author Alison Parkes, of the University of Glasgow in Scotland, said the findings support the decision by many parents to limit television time. Still, the researchers noted that this correlation does not equal causation. Excessive television watching by kids has also been linked to poorer physical health and performance in classrooms. Read more on mental health.

Cutting Medical Interns’ Hours Reduces Training Time, Increase Risks to Patients
Efforts to increase the amount of sleep by medical interns by reducing the number of continuous hours they work actually decreases the number of training opportunities and increases the risk to patients, according to a new study in the journal JAMA Internal Medicine. They also don’t get any more sleep in an average week. "Despite the best of intentions, the reduced work hours are handcuffing training programs, and benefits to patient safety and trainee well-being have not been systematically demonstrated," said study leader Sanjay Desai, an assistant professor of medicine at the Johns Hopkins University School of Medicine and director of the internal medicine residency program at the Johns Hopkins Hospital. "We need a rigorous study. We need data to inform this critical issue." Read more on access to health care.

On July 20, 2012, during a midnight showing at a local movie theatre in Aurora, Colorado, a gunman opened fire, killing and injuring unsuspecting moviegoers. Ultimately the massacre killed 12 and injured 57 — presenting an enormous challenge for local emergency dispatch, fire departments, police, hospitals, public health, and more, and requiring all to work together on an integrated response in the midst and the wake of a chaotic, unprecedented active shooter situation. Partners came together to share their lessons learned at the 2013 Public Health Preparedness Summit.

>>Read continued NewPublicHealth coverage from the Summit.

When the first 9-1-1 calls came in following the shooting, the University of Colorado Hospital, a level II trauma center, already had full emergency department — 49 out of 50 beds were filled.

“We’d been notified we were going to get three to five gun shot victims,” said Patrick Conroy, manager of support services and safety officer for the University of Colorado Hospital. “But we had this queasy feeling something was not quite right. We started notifying emergency services to get ready.”

Breast Cancer in Young Women May Be Up Slightly in Past Several Decades
Advanced breast cancer in women ages 25 to 39 may have increased since 1976, according to a new report in The Journal of the American Medical Association. In 2009 there were about 2.9 advanced cased per 100,000 younger women, up from 1.53 per 100,000 in 1976. The researchers say further study is needed to verify the numbers. In the mean time, they recommend that young women see a doctor if the notice lumps or other early indicators, and not simply assume they are too young to develop breast cancer. Read more on cancer.

Cohabitating Same-sex Couples Report Worse Health than Married Heterosexuals, Possibly Tied to Discrimination
Stress and discrimination may be the reason that cohabitating same-sex couples report generally worse health than do married heterosexuals, according to a new report in the Journal of Health and Social Behavior. The study looked at how the individuals describe their health, not at their health records. The same-sex male couples were 61 percent more likely to report poor or fair health and same-sex female couple were 46 percent more likely. "Research consistently suggests that 'out' sexual minorities experience heightened levels of stress and higher levels of discrimination, and these experiences may adversely affect the health of this population," said Hui Liu, lead author and an assistant professor of sociology at Michigan State University. "It may also be that same-sex cohabitation does not provide the same psychosocial, socioeconomic and institutional resources that come with legal marriage, factors that are theorized to be responsible for many of the health benefits of marriage." Read more on LGBT issues.

Poll: 1 in 5 Americans Know a Victim of Gun Violence
One in five Americans—and 4 in 10 black Americans—know a victim of gun violence, according to the latest Kaiser Health Tracking Survey. The poll measured personal experience and concerns about firearms. About 42 percent of Americans are worried about being the victim of gun violence, with racial and ethnic minority groups more likely to be concerned. About 75 percent of Hispanics, 62 percent of black Americans and 30 percent of white Americans say they are worried. Read more on violence.

AAP: Out-of-school Suspensions, Expulsions Harmful to Kids
Out-of-school suspensions and expulsions are generally counterproductive and can have profound long-term negative effects, according to the American Academy of Pediatrics (AAP). Data shows the youth are more likely to drop out of school, more likely to be involved in the juvenile justice system and will earn $400,000 less over a lifetime than a high school graduate. Such discipline also does not address potential underlying issues, such as drug abuse, racial tension, violence and bullying, according to AAP. AAP recommends early intervention programs to recognize and address behavioral and other problems. Recommendations also include a Positive Behavior Intervention and Support program to teach proper behavior at both the individual and school-wide levels. Read more on violence.

Study: 1 in 4 Admit to Bizarre Late-night Snacking
Approximately one in four students admit to creating and eating late-night crazy food concoctions, according to a new report in the International Journal of Eating Disorders. Researchers defined the relevant snacks as “strange food mixtures that you would be too embarrassed or ashamed to share with others” (e.g. sugar-covered scrambled eggs or mayo-smothered vegetables). While there is no inherent health danger in such mixing, health professionals recommend that people try to make healthy choices when selecting late-night snacks. About one-third of U.S. adults and nearly one in five youth ages 2-19 are obese, according to the U.S. Centers for Disease Control and Prevention. Read more on nutrition.

Study: Mediterranean Diet Good for Heart Health
A Mediterranean diet—rich in olive oil, nuts, fresh fruits, fresh vegetables and even red wine—is more effective than a low-fat diet at helping at helping people at high risk for cardiovascular disease to ward off health problems, according to a new report in the New England Journal of Medicine. Researchers found a 30 percent greater reduction in relative risk of a heart attack, stroke or death, according to lead author Miguel Angel Martinez-Gonzalez, MD, MPH, PhD, chairman of preventive medicine and public health at the Universidad de Navarra in Spain. He said the findings are likely to due to the good-quality fats and wide array of nutrients. The findings give further support to the effectiveness of a Mediterranean diet at preventing heart disease. Read more on heart health.

Study: IVF Does Not Affect Risk of Breast, Gynecological Cancers
In vitro fertilization (IVF) does not increase a woman’s risk of breast and gynecological cancers, according to a new study in the journal Fertility & Sterility. Researchers looked at the medical records of 67,608 women who underwent IVF between 1994 and 2011 and 19,795 women who sought treatment, did not receive it. They found no increase in the chance of being diagnosed with breast or endometrial cancer and only a slight increase in ovarian cancer depending on the times treated, which might have been the result of chance. Previous studies had linked IVF to increased risk of breast cancer and borderline ovarian tumors. Read more on cancer.

Studies Link Excessive Television as Kids, Violence as Adults
Reducing the amount of violent television programming a child watches may also reduce their aggression levels, according to two new studies in the journal Pediatrics. A New Zealand study found higher rates of criminal convictions in people who had watched more television as children, while a U.S. study found kids who watched “pro-social” programming were better behaved than their peers who watched regular programming. "It's not just the bad behaviors that they get from TV. They can get good behaviors, too," said the U.S. study's lead author, Dimitri Christakis, MD, MPH, director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute. The link between television and violence has been difficult for researchers to study because of the presence of so many other factors, but the findings do support previous research showing a link between watching too much television early in life and antisocial problems, according to study co-author Bob Hancox, MD, an associate professor in the department of preventive and social medicine at the University of Otago in Dunedin. Read more on violence.

NIH: Diabetes Control Much Improved in Past Two Decades
People are increasingly meeting the recommended goals for the top markers of diabetes control, according to a new study in the journal Diabetes Care. The "ABC's" of diabetes control include A1C (which assesses blood sugar levels), blood pressure and cholesterol. About 19 percent of people with diabetes met all three of the goals in 2010, up from only 2 percent in 1988. The National Institutes of Health and the U.S. Centers for Disease Control and Prevention conducted and funded the study. Still, the researchers say continued improvement is needed, especially for younger people and certain minority groups. Read more on diabetes.

An article in the New York Times reports that health departments in some states are increasing their efforts on gun safety and suicide prevention in part because of a startling finding by researchers at the Harvard School of Public Health: far more Americans die from guns they aim at themselves than in mass shootings.

By the numbers:

• Nearly 20,000 of the 30,000 deaths from guns in the United States in 2010 were suicides.
• Wyoming, Montana and Alaska are the states with the three highest suicide rates; they’re also on the list of top gun owning states.
• The national suicide rate has climbed by 12 percent since 2003.
• Suicide is the third-leading cause of death for teenagers.
• Suicide attempts using a gun are fatal 85 percent of the time; suicide attempts with pills are successful 2 percent of the time.

State health departments in Missouri, North Carolina and Wyoming, the state with the highest suicide rate, are giving out gunlocks. In New Hampshire some gun shops post flyers with warning signs for suicide and a recommendation to keep guns from people who are at risk of harming themselves. Some gun owners in Maryland are considering a similar outreach project.

>>Read the article.

>>Bonus Link: Read a NewPublicHealth post about the Surgeon General’s National Strategy for Suicide Prevention, launched last year.

A new study funded by Public Health Law Research, a program of the Robert Wood Johnson Foundation at Temple University, addresses the consequences of weak penalties for domestic violence offenders in the U.S.

Domestic violence, also known as intimate partner violence, accounts for an estimated 1,200 deaths and two million injuries among women each year. The new study, authored by Frank Sloan, PhD, professor of health policy and management at Duke University, and published in the journal Risk and Uncertainty, reviewed data from the North Carolina administrative courts and found that there are often repeat offenses for men arrested for domestic violence and that penalties don’t seem to significantly reduce repeat arrests or convictions.

Sloan points to low prosecution rates and minimal fines as reasons behind many repeat offenses. The study did find, however, that defendants who hired a private lawyer are less likely to be arrested or convicted during the follow-up period because the added costs may be a deterrent.  

Survey: Majority of Americans Support Stronger Gun Policies
The majority of Americans support all but four of 31 gun policies asked about in a recent survey by the Johns Hopkins Bloomberg School of Public Health. The policies are designed to reduce gun violence and include measures such as universal background checks (supported by 89 percent), banning the sale of military-style semiautomatic assault weapons (69 percent) and banning the sale of large-capacity ammunition magazines (68 percent). “This research indicates high support among Americans, including gun owners in many cases, for a wide range of policies aimed at reducing gun violence,” said study author Colleen Barry, PhD, MPP, an associate professor at the university. “These data indicate broad consensus among the American public in support of a comprehensive approach to reducing the staggering toll of gun violence in the United States.” Read more on violence.

CDC: Pregnant Women Should Receive Pertussis Vaccine Booster
The U.S. Centers for Disease Control and Prevention (CDC) now recommends pregnant women should get a booster tetanus, diphtheria and pertussis (Tdap) vaccine to help protect their newborn children from whooping cough. The vaccine schedule for children has them receiving their first pertussis vaccine at two months of age and they are not fully protected until six months. Vaccinating pregnant women will protect them whooping cough and also allow them to pass on immune cells to their children, according to Reuters. "It turns out that immunity wanes pretty quickly," said H. Cody Meissner, MD, a pediatrician from the Tufts University School of Medicine in Boston. "Without boosting with each pregnancy, a mother's immunity will wane and she will have much less immunity to pass on to the baby." Read more on maternal and infant health.

Study: Eating Your Main Meal Earlier May Improve Weight Loss
Eating an earlier lunch may improve your chances to lose weight, according to a new study in the International Journal of Obesity. The study found people in a weight-loss program who consumed lunch after 3 p.m. lost about 25 percent less weight than those who ate earlier. Researchers were careful to note that the study was performed in Spain—where lunch is often the day’s main meal—so are unsure how the results would apply to countries such as the United States. Still, the findings back up the traditional advice to eat your larger meal earlier in the day. "This is the first large-scale, long-term study to show that it is an important factor in weight-loss success for overweight and obese individuals," senior researcher Frank Scheer, an assistant professor of medicine at Harvard Medical School. Read more on obesity.