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Suspicious Infant Death

Suspicious Infant Death.

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Suspicious Infant Death

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  1. Suspicious Infant Death A Proposed National Data Set Michael Durfee MD APHA 2004

  2. Based on Data Match X3+and… “LA Model” • Data Match X3+ • 1 FBI UCR SHR (Cop Homicide) • 2 Vital Statistics (Coroner Homicide) • 3 Child Abuse Central Index (CPS) • + Child Death Review Team • LA Model – infants only (from above)

  3. Matching Data Sets Connect…` • Professions – • Justice • Health • CPS • More powerful data • State/local agencies

  4. Case Example of Data MatchResolves the “Puzzle” Ten week old falls from couch to floor Taken to closest hospital in coma (in a neighboring state) And… dies

  5. Coroner- Undetermined (neighboring state) FBI UCR SHR - Dad suspect (Local Police) Suspicious Death (local Child Death Review Team) Child Abuse Central Index, No Report (Local CPS)

  6. ` Team finds Coroner In neighboring state Tell law enforcement

  7. Dad convicted but no one reports to social services Three siblings left in home

  8. Matching data sets identifies missing records Siblings found and served

  9. Why Only Infant Cases • Manageable with present resources • <12 cases/year for most states • existing data (X3) • Avoid Extra Codes • Infant homicides are significant • 95%+ by caretaker • 40% of all caretaker homicide • Problem cases for adult oriented systems

  10. Studies - Single Data Sets

  11. State Infant Homicide Rates Vary up to 400%

  12. State Infant Homicide RatesCorrelate with… • Infant mortality rates • Pearson r = 0.79 with p <0.0001 • Quality of investigation • Missouri has systematic investigation • LA County changed cases to homicide

  13. Infant Rates Constant/Time(Differ from older homicide)

  14. Homicide by Age/Gender(Younger victim about equal)

  15. Homicide /Rate /Age /Race(Rates for all ages, not equal)

  16. Match Infant Data X3(ican-ncfr.org)

  17. Texas - Suspicious Infant Death Rate/Year (X3)(CPS cases higher – expected)

  18. California Infant Homicide Rate/Year(CPS low - missed data entries)

  19. Child Abuse and Neglect Fatalities: Children < 6 Years, California 1992-3 VS Injury Deaths N=1165 VS Homicide N=214 DOJ Homicide N=243 VS CAN N=90 DOJ CAN N=196 N=56 DOJ CACI N=128

  20. LA MODELCASE DATA MATCH

  21. LA Model Sample Case • 3 month male father threw against wall • “Manner” of death X3 • Homicide (UCR and VS) no record CPS • Action • Father convicted • Case reported to CACI • CPS records found in two counties • Counties meet to share data • Siblings located, with mom, voluntary services

  22. National Infant Data X3+ • National data with common language • Teams could compare data and cases (e.g., State infant homicide rates) • Connect cases across state/county lines • Support more complex data systems • CDC National Violent Death Child death indices

  23. Resources • Web Site - ican-ncfr.org • Team Reports • “51 State” Comparison • Infant Data x3 / State • LA Model – 2005 • APHA Caucus on Family Violence • Michaeld55@aol.comaeld55

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