Development of a health service at a rural community college in Appalachia

The successful implementation by a large public university health service of a satellite clinic involves a number of processes and funding issues. The authors discuss the development of such a program at a small community college in Appalachia. The first 4 years' experience in operating the satellite clinic created a number of valuable management lessons that they believe could assist others with similar goals for extending their services.     

The relationship between maternal depression and child outcomes in a child welfare sample: implications for treatment and policy

Maternal depression is an extremely important parenting variable in relation to child general health. This investigation addressed the issue of maternal depression as it relates to the lives of children seen by child welfare authorities. Maternal depression was investigated in the context of the increasing rate of children coming to the attention of the London and Middlesex Children's Aid Society. A variety of child outcomes including those of particular relevance to child welfare, specifically disorders of attachment and neglect and physical abuse, school‐related variables, conduct disorder and psychological distress, were investigated. The relative contribution of maternal depression along with measures of socioeconomic status and social isolation to childhood risk was examined. Results indicated that the rate of maternal depression doubled during the years 1995–2001. Maternal depression was related to children entering care through wardship. Additional poor child outcomes such as attention deficit disorder, conduct disorder and emotional adjustment were also related to maternal depression. The findings are discussed in terms of treatment and policies that can lower the risk to children through effective intervention with depressed mothers.     

THE ASSOCIATION OF POVERTY WITH CHILD WELFARE SERVICE AND CHILD AND FAMILY CLINICAL OUTCOMES

The influences of poverty, family status and violence in the lives of children and families seen at a large urban children's aid society are investigated. Rates of social assistance dependency of child welfare families in 1995 and 2001 are compared. While the rate of poverty of child welfare families is stable across the two time periods, the ability of families to cope with poverty has dramatically changed, with the percentage of children from impoverished families being admitted into care nearly doubling across the six-year period. Violence as a mitigating factor in the relationship between poverty, the extent of child welfare service and child and family outcomes is also reported. Suggestions for enabling women who are caught in the complexity of choosing between physical safety and poverty are reported.

Les influences de la pauvreté, de la position sociale de la famille et de la violence sur la vie des enfants et des familles vues à une grande société urbaine d'aide à l'enfance sont examinées. Les taux de dépendance des familles vis-à-vis des programmes de protection de l'enfance en 1995 et 2001 sont comparés. Tandis que le taux de pauvreté des familles qui se servent du système de protection de l'enfance est stable à travers les deux périodes de temps, la capacité des familles de faire face à la pauvreté a radicalement changé, le pourcentage d'enfants de familles appauvries qui sont placés dans des familles d'accueil ayant presque doublé à travers la période de six ans. On fait aussi compte-rendu de la violence comme facteur atténuant dans le rapport entre la pauvreté, l’étendue du service de protection des enfants et les résultats pour les enfants et les familles. On résume aussi des suggestions favorisant l'habilitation des femmes qui se trouvent coincées dans la complexité de choisir entre la sûreté physique et la pauvreté.