Child Abuse and Neglect
Identification of child abuse and neglect fatalities presents unique challenges. A study published in Pediatrics (2002) that reviewed nine years of children’s death certificates estimated that about half of child abuse and neglect deaths were coded inconsistently. In cases of abuse, the cause of death may be attributed to blunt force trauma, with a manner of homicide, but the lack of identification of perpetrator on death certificates makes it very difficult to correctly code as child abuse.
Even more challenging is the identification of neglect fatalities. These are often classified with manners other than homicide. They may be found in deaths classified as accident (young child runs out in the street with no parental supervision), natural (child’s medical needs ignored by caregivers), suicide (child’s significant mental health needs go unmet), or Undetermined. The Centers for Disease Control and Prevention (CDC) funded state-level surveillance projects which concluded that local review teams are the most accurate way to identify deaths due to child abuse and neglect. (McCurdy J, Wetterhall S, Gibbs D, & Farris T. Child Maltreatment Surveillance: Recommended Model System CDC, May 22, 2006.)
For the purposes of Child Death Review, local teams indicate if they believe that someone either caused or contributed to the death by some act, or failure to act. In Michigan, local teams reviewed 17 cases they determined to be abuse-related fatalities, and 32 cases that they determined to be neglect-related fatalities in 2014*. Not every child’s death is reviewed, so these numbers are almost certainly an undercounting. Because of this fact, as well as the coding challenges and varying definitions, these numbers do not reflect counts of abuse or neglect fatalities reported by other state entities, such as MDHHS’s CPS Program Office or Division for Vital Records and Health Statistics.
More information on child abuse and neglect and prevention is available on the National Center for Fatality Review and Prevention Child Abuse and Neglect page.
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*Source: Michigan Child Death Review