by Stephen D. Haner
As a pediatric anesthesiologist in Texas, Dr. Dyann Daley saw far too many victims of child abuse in the OR. One horrible case in particular spurred her to move beyond treatment to thoughts of prevention, with a data-driven approach that should fascinate all Baconistas.
Preventing child abuse is not as simple as preventing the flu or even malnourishment. There are plenty of thoughts on the why of child abuse, including the observation that it can be patterned behavior. The insight Dr. Daley and others behind Predict-Align-Prevent brought to the discussion was to focus on the where. Looking specifically at her home of Fort Worth, the group used spatial risk modeling to track a number of adverse outcomes believed to correlate with mistreatment of kids.
The results are shown in two maps – one predictive and the other showing how the next year’s case statistics matched the predictions. That the two maps lined up so well may not be surprising. But Dr. Daley was surprised that poverty was not the strongest correlation with child abuse. Domestic violence, aggravated and sexual assault and children running away from home – those are the other problems with the strongest correlations.
Dr. Daley was at Lewis Ginter Botanical Garden on Tuesday presenting her work to a child abuse and prevention conference, jointly sponsored by Families Forward Virginia and the state Department of Social Services. Predictive analytics is only worth doing if it then drives decisions on what preventive measures to take, where to focus the efforts and how to measure what is working.
What has been done in Fort Worth is now being done in the City of Richmond, with a similar mapping effort underway down to the half-block level. That goal will be the same, to use the map to encourage the relevant players (social services, police, medical providers and the schools) to cooperate on effective prevention. The data will also locate community assets – schools, parks, services, churches, licensed day care – to see if they have any positive impact and how.
The work is not universally applauded, and people in the audience Tuesday expressed concerns that sections of the city will see additional stigma or stereotyping based on the maps. The researchers reported that getting some of the data they want is not quickly shared, and it is being done inside DSS because at least the child welfare data is already in-house. They also stressed that the data does not deal with causation, only correlation.
Disclaimer: I’m on the board of directors for Families Forward Virginia. It was formed last year through a merger of Prevent Child Abuse Virginia (PCAV) and the Comprehensive Health Investment Project (CHIP) of Virginia, and serves as the state office for three evidence-based home visitation programs all across the Commonwealth. CHIP was a paying client from 2013 through 2017, but now I’m working for free. I guess Jim will chalk me up as another social justice warrior.
I’ll keep my eyes open for more information on the Virginia effort with predictive analytics and pass it on.
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