Amy HunterLaura ReeseIt's National Public Health Week! We’re spotlighting this year’s daily NPHW themes with a series of guest posts from APHA members. Today’s NPHW theme is violence prevention, and our guest post comes from Amy Hunter, PhD, MPH, (pictured at left), research scientist at Connecticut Children’s Injury Prevention Center and assistant professor of pediatrics and public health sciences at the University of Connecticut; and Laura Schwab Reese, PhD, MA, (pictured at right), assistant professor of public health at Purdue University in Indiana. Hunter currently serves as chair-elect of APHA’s Injury Control and Emergency Health Services Section; Schwab Reese is the immediate past chair.

Research on adverse childhood experiences, or ACEs, increasingly shows that what happens as a child can reverberate long into adulthood. This is especially true when it comes to the domino effects of addiction.

ACEs — which can include child abuse and neglect, exposure to intimate partner violence, substance misuse in the home, poor caregiver mental health and economic insecurity — can often result in substantial trauma and impaired healthy childhood development, with the effects sometimes far-reaching and persisting for years. In fact, research shows that ACEs and their associated trauma alter nearly every system in the human body, including the cardiovascular, digestive, endocrine, immune, muscular, nervous and reproductive systems. In turn, ACEs can substantially increase the risk of premature death. Surveys of U.S. adults suggest that 61% experienced ACEs during their childhoods.

Unfortunately, the nation’s ongoing drug use and addiction epidemic is only exacerbating the problem. Recent data find that over 8 million U.S. children live with at least one parent who misuses substances. The situation can increase the risk of abuse in the home and is often associated with a lack of supervision and unsafe household environments. One particularly alarming consequence is that children are finding and ingesting dangerous drugs, leading to higher rates of poisoning-related pediatric emergency room visits.

Poisonings are now the fifth leading cause of violent death among U.S. children from birth to age 9. To better understand the circumstances surrounding these deaths, we recently analyzed fatal child poisonings in 17 states, including data from law enforcement and medical examiner narratives and toxicology reports. It turns out that more than 50% of fatal child poisonings involved opioids, suggesting a tragic synergy with the evolving drug epidemic.

Relatively few of these deaths were intentional. A quarter of poisoning-related fatalities were a result of a homicide-suicide, and several poisonings were associated with a custody battle or mental health crisis. In some cases, the parent intended to give the child medicine but lost track of the dose (usually because they were under the influence) or gave the drug to induce sleep. Far more deaths resulted from unsafely stored prescriptions or illicit drugs combined with inadequate supervision.

But there are ways and resources to help prevent these deaths:

  • If someone you know is storing prescription or illicit drugs unsafely, help them identify ways to keep drugs away from their children. There are a number of educational resources already available, such as Up & Away, which offers families easy strategies for keeping medicines out of the reach of children.
  • Educate parents and guardians about the dangers of giving their children medication to induce sleep.
  • Call for increased availability of naloxone, an opioid overdose reversal drug, in homes with vulnerable children.
  • Advocate for expanded access to treatment and recovery, which can help families overcome the physical and emotional toll of addiction.

Children are among the most vulnerable members in our society. They need caregivers to keep them safe until they’re able to protect themselves and, sometimes, struggling parents need help to make that a reality. Join us in supporting and advocating for laws and policies that improve the holistic health and well-being of families now and into the future.

To learn more about National Public Health Week and get involved, visit And don’t forget to join APHA and public health partners nationwide for the annual NPHW Twitter Chat today at 2 p.m. EST. Follow @NPHW on Twitter and use the hashtag #NPHWChat.