Wednesday, October 23, 2013

Characteristics of, Responses to, and Prevention of Child Maltreatment Deaths

The U.S. National Child Death Review Case Reporting System offers an increasingly large repository for case information which can help communities understand, respond to, and prevent child maltreatment (CM) deaths, as highlighted in an article published in Child Abuse and Neglect online this month. 

Beyond fatality, CM impacts living children, families, and communities medically, emotionally and economically. To improve data collection about CM and non-homicide fatalities from child death reviews, the Maternal and Child Health Bureau funded the National Center for Review and Prevention of Child Deaths to create and implement a national data-collection system for child death review information. The U.S.National Child Death Review Case Reporting System (NCDR-CRS) is an internet-based data-reporting structure that has been used since 2005 among an increasing number of U.S. states. The objectives of this study are to (1) describe the case characteristics of CM deaths in a large U.S. population, (2) systematically assess risk factors and community responses as a result of those reviews, and (3) compare these case characteristics in NCDR-CRS with other published series.

The authors used cases from 2005 to 2009 in the NCDR-CRS to compare child and offender characteristics and to link that information with actions taken or recommended by child death review teams (CDRTs). Child, caregiver, and offender characteristics and outcomes were compared to CDRT responses, and findings were compared to published case series.

The authors found that
  • As of July 1, 2012, there were 101,501 child death review reports in the NICDR-CRS from 37 U.S. states. Although a small number of near-fatalities were included, most (99 percent) of the records contained review information for deaths, and 45,947 (45 percent) were recorded by states as complete reviews during 2005-2009.
  • CM caused or contributed to 2,285 of the deaths recorded as complete during this period.
  • CDRTs identified several child and offender characteristics among these deaths, but a large proportion of data was missing for some child variables.
  • CM cases in the NCDR-CRS have characteristics similar to other published studies of CM deaths.
  • Of the 2,285 maltreatment deaths analyzed here, 1,020 cases had actions or strategies recommended or planned, and CDRTs recorded that 109 were actually implemented as of July 1, 2012.
The authors conclude that "a variety of prevention initiatives have been recommended by local CDRTs, and additional studies are needed to expand our use of these insights for preventing future deaths."