‘Violent’ deaths of children in England and Wales and the major developed countries 1974–2002: possible evidence of improving child protection?

Abstract

Child protection services are criticised for failing to prevent abuse but demonstrating successful prevention is impossible as it is trying to prove a 'negative'. The alternative is to examine 'failures', i.e. the 'violent' deaths of children (0-14 years) to indicate whether matters are improving or deteriorating. This paper uses the latest World Health Organisation data to compare children's 'violent' deaths in England and Wales with those in other major developed countries.To account for possible 'hidden' under-reported abuse deaths, undetermined, i.e. 'other external causes of death' (OECD) and fatal accidents and adverse events (AAE), deaths are also analysed along with homicides, to compare all 'violence-related' deaths between 1974 -76 and 2000 -02. England and Wales infant (<1 year) homicide rates were annually 57 per million but fell to 17 per million, a 74% fall. Infant AAE deaths fell in every country with England and Wales falling from 341 per million to 71 per million, a 76% reduction. Both these results were significantly better than those of eight other major developed countries, although England and Wales infant OECD at 26 per million, were high compared to the major developed countries.In the 1970s, combined 'violent' deaths of all children (0-14 years) (homicide, OECD and AAE) in England and Wales were 203 per million, they are now 61 per million, a 70% decline with only Italy having lower rates. The worst rates were in the USA which had the highest combined 'violent' death rate. These overall results in the major reductions of 'violence-related' deaths in England and Wales can be a boost to the morale of front-line staff and provide the public

Patterns of child death in England and Wales

“…50 There is some evidence that these rates have fallen over the past 30 years. [50][51][52] In contrast, rates of violent death in adolescence have not fallen, particularly amongst adolescent males, and an estimated 32-117 young people aged 15-19 years die violent deaths each year (up to 4.2 per 100,000 males and 2.0 per 100,000 females). 50 Accurate estimates are difficult because of the difficulties in classification and in identifying the cause of death.…”

Fatal child maltreatment in England, 2005–2009

“…It has been estimated that at least one to two children die each week in the UK at the hands of their carers (Green, 1998), although there is some evidence that overall numbers and rates of violent child deaths may be falling (Pritchard & Sharples, 2008;Pritchard & Williams, 2009;Sidebotham, Atkins, & Hutton, unpublished). The true incidence of fatal child maltreatment, however, is not known.…”

Consistency in Suicide Rates in Twenty-Two Developed Countries by Gender over Time 1874–78, 1974–76, and 1998–2000

“…It is argued that changes in national mortality rates of plus or minus 10% (a ratio of 0.10) may have clinical significance (Kolmos & Bach, 1987) but to err on the side of caution, as in previous comparative international studies, substantial is defined here as when a ratio falls outside 0.80-1.20, equivalent to a change of 20% over time (Pritchard & Amunalla, 2007;Pritchard, Baldwin, & Myers, 2004;Pritchard & Hansen, 2005a, b;Pritchard & Staples, 2008).…”

“…Utilizing WHO data, which are collated uniformly, and using ratio of changes between countries has been said to have resolved most of these crossnational problems (Shah & De, 1998), reflected in examples of successful international studies on a range of problematic mortality, (Pritchard & Amunalla, 2007;Pritchard et al, 2004;Pritchard & Hansen, 2005a, b;Pritchard & Staples, 2008;Pritchard & Wallace, 2006).…”