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Profile in Public Health Law: Jennifer Matjasko, PhD, MPP

Title: Health Scientist/Associate Chief of Science, Research and Evaluation Branch, Division of Violence Prevention, Centers for Disease Control and Prevention (CDC)

Education: PhD and MPP in Public Policy, University of Chicago; BS in Human Development and Family Studies, Penn State University

Public Health Law News (PHLN): Please describe your path to your current position.

Matjasko: I became interested in conducting research with children and families early in my undergraduate career. My first work-study job was in a lab where I assisted in conducting the Strange Situation, an experiment designed to uncover attachment styles in infants and toddlers. I also assessed infant emotionality in a variety of experimental conditions and coded co-parenting styles during home visits. I also taught preschool during this time. Across my research and practice experiences, I noticed that families under economic distress faced a number of parenting and child development challenges that affected how children learned and behaved. Because of these experiences, I wanted to understand how poverty was related to family functioning and child well-being and pursued that topic for my honors thesis. While I was working on my thesis, I became very interested in the policy implications of the research and wanted to hone my skills in policy analysis and evaluation. This ultimately led me to pursue my doctorate in public policy. During my graduate career, my training focused on child and family policy, with a concentration in family and community violence. While I didn’t know it at the time, my undergraduate and graduate research and training experiences set a strong foundation for the work that I do at CDC. I work in the Division of Violence Prevention (DVP), where I conduct and support research on the prevention of multiple forms of violence. My past experiences are in line with DVP’s focus on healthy parenting, positive early education experiences, and approaches that affect the economic conditions of families.

PHLN: How did you become interested in public health?

Matjasko: I always had an interest in doing research that can be put into action to help improve the lives of children and youth. During one of my graduate school fellowship experiences, I worked with New York City’s Department of Probation, where I pulled together the best available evidence on how to best prevent recidivism among the juvenile population. Reading through the department’s case files, I was struck by how young people’s involvement in the justice system had influenced their lives and how preventing their involvement in delinquency and violence would have set them on a potentially better path. This reinforced my interest in the broader systems and supports for communities and families that might help create healthier contexts for youth. As a result, I spent several months doing an applied evaluation of Chicago’s Community Economic Development Law Program, which is a program of the Chicago Lawyers’ Committee for Civil Rights. The program provides transactional pro bono legal representation to nonprofit organizations involved in community development, affordable housing, and social services. It also provides pro bono representation to low-income entrepreneurs and first-time home buyers. Through that experience, I was able to elevate the importance of community and family supports and their salience to child and adolescent well-being. This is one of the cornerstones of a public health approach to preventing violence.

PHLN: What do you do in your day-to-day role in DVP?

Matjasko: I am the associate chief of science in DVP’s Research and Evaluation Branch. In this role, I support the scientific functions of the branch. This includes reviewing products for dissemination to ensure they are supported by solid data, providing scientific consultation and mentorship to branch scientists, leading scientific strategic planning efforts, and contributing to the violence prevention field through scholarly publications and presentations. I am also the lead science officer on a DVP-funded contract designed to better understand the opioid crisis’s impact on children and families, including community supports and services that might be effective in preventing adverse childhood experiences (ACEs) and children’s exposure to violence. I also serve as the principal investigator for a CDC Foundation project that will bring the best science and practice to an update of CDC’s 2007 publication, Preventing Child Sexual Abuse Within Youth-serving Organizations: Getting Started on Policies and Procedures[PDF – 4.6MB]. The updated publication will provide youth-serving organizations with recommendations on how to create safe and protective environments for all children and youth. I also serve as a division subject matter expert in the areas of child abuse and neglect, child sexual abuse, and sex trafficking.

PHLN: What are ACEs and how do they relate to your work?

Matjasko: Safe, stable, nurturing relationships and environments are critical to children’s health and well-being. Unfortunately, many children don’t have these types of relationships and environments and instead experience ACEs.ACEs are preventable, potentially traumatic events that occur in childhood (0–17 years), such as neglect, experiencing or witnessing violence, and having a family member attempt or die by suicide. ACEs also include aspects of children’s environment that can undermine their sense of safety, stability, and bonding, such as growing up in a household with substance misuse, mental health problems, or instability due to separation from a parent or incarceration of a parent, sibling or other member of the household. In terms of the specific work that I do in the Research and Evaluation Branch, I help support and advance the research on ACEs, with a focus on how to stop child abuse and neglect from happening in the first place. For example, the research study I lead is designed to better understand the opioid crisis’s impact on children and families. This study will elevate community-level opportunities for preventing ACEs among families who are experiencing substance use issues. Preliminary evidence from the field is already pointing to the importance of community and economic supports for families. We are also learning about how substance use and child welfare policies may work together (or not) so that children experience safe, stable, and nurturing relationships and environments.

PHLN: Why is what happens to people during childhood important later in life?

Matjasko: About 61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE, and nearly one in six reported they had experienced four or more types of ACEs. ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities. Preventing ACEs could potentially reduce a large number of health conditions. For example, up to 1.9 million cases of heart disease and 21 million cases of depression could have been avoided by preventing ACEs. A November 2019 ACEs Vital Signs published by CDC provides more details on the ways in which ACEs can have lifelong impacts on health and well-being.

PHLN: How do law, policy, and social systems affect children’s ability to thrive?

Matjasko: Law, policy, and social systems have the potential to reach more children and families than individual-level programs like therapy. They also play a role in creating safe, stable, and nurturing relationships and environments. CDC has developed technical packages to help states and communities prevent violence based on the best available evidence. Technical packages compile a core set of strategies to achieve and sustain substantial reductions in a specific risk factor or outcome, and they help communities and states prioritize prevention activities based on the best available evidence. Recently, CDC published a resource[PDF – 3.7MB] specific to preventing ACEs. This resource and the other violence prevention technical packages contain policy- and systems-level approaches that have the potential to create healthy contexts for children to thrive. For example, the Earned Income Tax Credit (EITC) helps families increase their income while incentivizing work or offsetting the costs of child-rearing. The federal EITC is a refundable credit originally designed to encourage work by offsetting the impact of federal taxes on low-income families. The EITC has been shown to reduce rates of child abuse and neglect. It is hypothesized that the EITC reduces child abuse and neglect by reducing parental stress and improving childcare arrangements, both of which are important factors in creating healthy environments where children can thrive.

In addition, pro bono legal services to support community development efforts (similar to Chicago’s Community Economic Development Law Program described earlier) can also increase community resources and family supports by helping low-income individuals overcome key legal barriers to economic opportunities (e.g., entrepreneurship and home buying). Similarly, microfinance programs provide access to small amounts of capital in the form of credit (small business loans), savings, microinsurance, or financial incentives. Microfinance programs have been shown to reduce intimate partner violence and child abuse in developing countries and may play a role in creating healthy environments where children can thrive.

PHLN: As we move into summer with many children already having been out of school for a long time, what kind of gaps might there be in the safety net for children? And what kinds of support and assistance do communities need to ensure their children flourish during this time?

Matjasko: Research[PDF – 1.5MB] shows that some forms of violence peak in the summer. As a result, children and youth may be more likely to experience and witness violence in the summer months. Out-of-school time is associated with an increased risk of youth violence perpetration and victimization, which is likely due to unstructured and unsupervised time with peers. This is also a time when reports of child abuse and neglect might decrease because teachers, as mandatory reporters[PDF – 5.5MB], are not in contact with their students. Mandatory reporters are people in professions that are in regular contact with children are required to report suspected cases of child abuse and neglect. As a result, these decreases in reports might not reflect actual decreases in child abuse in neglect. It just might reflect the fact that actual cases go undetected in the summer.

Evidence consistently shows that connecting children and youth to caring adults can prevent violence perpetration and victimization. Mentoring programs (e.g., Big Brothers/Big Sisters) are effective in providing children and youth with safe, stable, and nurturing relationships that help protect them from being exposed to violence. In addition, bolstering supports to parents and families during this time might also prevent child abuse, neglect, and other ACEs. Economic supports, such as subsidized childcare, can alleviate parental stress while also providing children with positive and supportive relationships with caring adults in community settings.

PHLN: How might communities and policy makers use the two Division of Violence Prevention resources for preventing child abuse and neglect and preventing adverse childhood experiences?

Matjasko: DVP has released implementation guidance for the violence prevention technical packages. This guidance is designed to support state and local health agencies and other stakeholders who have a role in planning, implementing, and evaluating violence prevention efforts. It has information on planning, partnerships, policy efforts, choosing strategies and approaches, adaptation, implementation, and evaluation. The guidance also has corresponding tools, stories, tip sheets, and resources related to each phase of implementation.

PHLN: What do you like best about your job?

Matjasko: I love the fact that my job is to apply our best science to better prevent ACEs and all forms of violence in the United States. CDC’s approach to violence prevention really resonates with my educational and professional experiences. I also appreciate that we connect with partners across multiple sectors to better prevent violence and increase the reach of our work. Promoting safe, stable, and nurturing relationships and environments for all children and youth is vital to their current and future success, the health and resilience of their communities, and the health of our nation. I value the opportunity to work on this important issue.

PHLN: Do you have any hobbies?

Matjasko: Yes, it is important for me to have a sense of balance in my life. I am an avid cyclist. I love exploring the Atlanta food scene—especially up-and-coming chefs who get their starts in hole-in-the-wall places. You can also regularly find me at live theater venues and on Atlanta-area lakes in the summer. I’m also committed to community service. I am a former Big Sister, and I currently volunteer at the Atlanta Humane Society.

PHLN: Is there anything else you would like to add?

Matjasko: We know from CDC data that violence affects every community. CDC has also shown that violence can be prevented. We know that by stopping violence before it starts, we can improve mental health, physical health, and the prosperity of individuals, communities, and our nation. DVP has violence prevention tools online at VetoViolence. It’s important to help people and communities recover from experiences with violence. Finally, it’s also important to continue to advance our understanding of the unique role that law and policy play in creating the contexts where all children can grow up in safe, stable, and nurturing relationships and environments. This includes conducting additional research on the effects that laws and policies have on multiple forms of violence. It also includes providing legal and practical supports to individuals and communities so that they prosper. For more information on all of CDC’s violence prevention topics, research, and programs, please visit www.cdc.gov/violenceprevention.