Underascertainment of Child Maltreatment Fatalities by Death Certificates, 1990–1998

Crume, Tessa; DiGuiseppi, Carolyn; Byers, Tim; Sirotnak, Andrew; Garrett, Carol

doi:10.1542/peds.110.2.e18

Cited by 145 publications

(85 citation statements)

References 8 publications

(7 reference statements)

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“…50 Accurate estimates are difficult because of the difficulties in classification and in identifying the cause of death. [53][54][55][56] Patterns of violent death vary across the age spectrum, and do not form a homogeneous group (Box 2). [57][58][59] A study of 267 Serious Case Reviews into fatal cases of maltreatment in…”

Section: Fatal Maltreatment and Deaths From Assaultmentioning

confidence: 99%

Patterns of child death in England and Wales

et al. 2014

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Over the past century child mortality rates have fallen to very low levels in all developed countries. However, there remain wide variations both between and within countries, and in many child deaths factors can be identified which could be modified to reduce the risks of future deaths. An understanding of the nature and patterns of child death and of the factors contributing to child deaths is essential to driving preventive initiatives. This paper reports on the epidemiology of child deaths in England and Wales. It draws on available data, particularly death registration data and other available datasets, along with published literature to highlight the issues relevant to reducing child deaths in developed countries. We highlight the different patterns of mortality at different ages within five broad categories of death: perinatal causes, congenital abnormalities, acquired natural causes, external causes, and unexplained deaths. Within each category we explore what is known about the main causes of death and some of the contributory factors and highlight how this knowledge may be used to help drive prevention initiatives.

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Section: Fatal Maltreatment and Deaths From Assaultmentioning

confidence: 99%

Patterns of child death in England and Wales

et al. 2014

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“…Detailed review of child deaths in Missouri, North Carolina, Colorado, and, more recently, Michigan, California, and Rhode Island has revealed that approximately half of child abuse fatalities are unrecognized in vital statistics data. [3][4][5][6] The incidence of sudden infant death syndrome (SIDS) has decreased significantly since the 1992 AAP recommendations for safe sleeping positions for infants. 7,8 Evaluation of more recent declines in SIDS rates in the United States suggest that, despite the significant decreases in SIDS deaths over the past 15 years, more recent declines might be attributable to an increase in diagnostic coding of asphyxia, suffocation, and other causes of sudden, unexpected infant death.…”

Section: Introductionmentioning

confidence: 99%

Child Fatality Review

Neglect¹,

Prevention²

2010

Pediatrics

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Injury remains the leading cause of pediatric mortality and requires public health approaches to reduce preventable deaths. Child fatality review teams, first established to review suspicious child deaths involving abuse or neglect, have expanded toward a public health model of prevention of child fatality through systematic review of child deaths from birth through adolescence. Approximately half of all states report reviewing child deaths from all causes, and the process of fatality review has identified effective local and state prevention strategies for reducing child deaths. This expanded approach can be a powerful tool in understanding the epidemiology and preventability of child death locally, regionally, and nationally; improving accuracy of vital statistics data; and identifying public health and legislative strategies for reducing preventable child fatalities. The American Academy of Pediatrics supports the development of federal and state legislation to enhance the child fatality review process and recommends that pediatricians become involved in local and state child death reviews.

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“…In addition, compared with vital records, child-fatality-review programs often document detailed information about the cause and circumstances of death and record information on a wider variety of risk factors. 5,7,11 We published a case-control study 2 in Pediatrics in 2002 using the first 3 years of Missouri Child Fatality Review Program (CFRP) data (1992)(1993)(1994). We reported that children residing in households with adults unrelated to them were 8 times as likely to die of maltreatment than children residing with only 2 biological parents and showed no increased risk of maltreatment death to children in households with a single parent and no other adult residents.…”

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Child Deaths Resulting From Inflicted Injuries: Household Risk Factors and Perpetrator Characteristics

2005

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ABSTRACT. Objective. To determine the role of household composition as an independent risk factor for fatal inflicted injuries among young children and describe perpetrator characteristics.Design, Setting, and Population. A population-based, case-control study of all children <5 years of age who died in Missouri between January 1, 1992, and December 31, 1999. Missouri Child Fatality Review Program data were analyzed. Cases all involved children with injuries inflicted by a parent or caregiver. Two age-matched controls per case child were selected randomly from children who died of natural causes.Main Outcome Measure. Inflicted-injury death. Household composition of case and control children was compared by using multivariate logistic regression. We hypothesized that children residing in households with adults unrelated to them are at higher risk of inflicted-injury death than children residing in households with 2 biological parents.Results. We identified 149 inflicted-injury deaths in our population during the 8-year study period. Children residing in households with unrelated adults were nearly 50 times as likely to die of inflicted injuries than children residing with 2 biological parents (adjusted odds ratio: 47.6; 95% confidence interval: 10.4 -218). Children in households with a single parent and no other adults in residence had no increased risk of inflicted-injury death (adjusted odds ratio: 0.9; 95% confidence interval: 0.6 -1.9). Perpetrators were identified in 132 (88.6%) of the cases. The majority of known perpetrators were male (71.2%), and most were the child's father (34.9%) or the boyfriend of the child's mother (24.2%). In households with unrelated adults, most perpetrators (83.9%) were the unrelated adult household member, and only 2 (6.5%) perpetrators were the biological parent of the child.Conclusions. Young children who reside in households with unrelated adults are at exceptionally high risk for inflicted-injury death. Most perpetrators are male, and most are residents of the decedent child's household at the time of injury. Using vital-records data makes it possible to conduct large, population-based studies to identify risk factors for fatal inflicted injuries. It is well documented, however, that studies based on vital records severely underestimate child maltreatment deaths, with 50% to 85% of child maltreatment deaths misclassified as resulting from other causes. [3][4][5][6][7] In addition, vital-records data are typically limited to a small subset of maternal and child variables and provide no information on household composition, the perpetrators, or their relationship to the decedent child. This combination of pronounced misclassification and lack of risk-factor information in vital records severely limits the usefulness of these data for child-maltreatment research. 1,[8][9][10] Combining data from multiple sources, now a common practice in many state-based child-fatalityreview programs, can greatly reduce the misclassification of maltreatment fatalities as resulting from other c...

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Underascertainment of Child Maltreatment Fatalities by Death Certificates, 1990–1998

Cited by 145 publications

References 8 publications

Patterns of child death in England and Wales

Patterns of child death in England and Wales

Child Fatality Review

Child Deaths Resulting From Inflicted Injuries: Household Risk Factors and Perpetrator Characteristics

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