Why is the problem of violence against children so much more acute in the US than anywhere else in the industrialised world, asks Michael Petit, President of Every Child Matters.
Over the past 10 years, more than 20,000 American children are believed to have been killed in their own homes by family members. That is nearly four times the number of US soldiers killed in Iraq and Afghanistan.
The child maltreatment death rate in the US is triple Canada's and 11 times that of Italy. Millions of children are reported as abused and neglected every year. Why is that?
Part of the answer is that teen pregnancy, high-school dropout, violent crime, imprisonment, and poverty - factors associated with abuse and neglect - are generally much higher in the US.
Further, other rich nations have social policies that provide child care, universal health insurance, pre-school, parental leave and visiting nurses to virtually all in need.
In the US, when children are born into young families not prepared to receive them, local social safety nets may be frayed, or non-existent. As a result, they are unable to compensate for the household stress the child must endure.
In the most severe situations, there is a predictable downward spiral and a child dies. Some 75% of these children are under four, while nearly half are under one.
Geography matters a lot in determining child well-being. Take the examples of Texas and Vermont.
Texas prides itself in being a low tax, low service state. Its per capita income places it in the middle of the states, while its total tax burden - its willingness to tax itself - is near the bottom.
Vermont, in contrast, is at the other extreme. It is a high-tax, high-service state.
Mix of risks
In looking at key indicators of well-being, children from Texas are twice as likely to drop out of high school as children from Vermont. They are four times more likely to be uninsured, four times more likely to be incarcerated, and nearly twice as likely to die from abuse and neglect.
In Texas, a combination of elements add to the mix of risks that a child faces. These include a higher poverty rate in Texas, higher proportions of minority children, lower levels of educational attainment, and a political culture which holds a narrower view of the role of government in addressing social issues.
Texas, like many other traditionally conservative states, is likely to have a weaker response to families that need help in the first place, and be less efficient in protecting children after abuse occurs.
The sharp differences between the states raises the question of an expanded federal role.
Are children Texas children first? Or are they first American children with equal opportunity and protection?
A national strategy, led by our national government, needs to be developed and implemented. For a start, the Congress should adopt legislation that would create a National Commission to End Child Abuse and Neglect Fatalities.
And no children's programmes should be on the chopping block, federal or state. Children did not crash the US economy. It is both shortsighted economic policy and morally wrong to make them pay the price for fixing it.
But instead as the US economy lags, child poverty soars, and states cut billions in children's services, we are further straining America's already weak safety net.
Inevitably, it means more children will die. The easy answer is to blame parents and already burdened child protection workers. But easy answers don't solve complex problems.
And with millions of children injured and thousands killed, this problem is large indeed, and it deserves a large response.
Michael Petit is the president of Every Child Matters. He served as the state of Maine's human services commissioner, and as deputy of the Child Welfare League of America.