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INFANT HOMICIDE DATA

INFANT HOMICIDE DATA. NAPHSIS / NCHS We measure babies. Our measurements measure us Michael Durfee MD. My Background Child Psychiatrist Career – Child Abuse Neglect. Started Child Death Review 1978 Projects today Track neonates”at risk, substance abue”

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INFANT HOMICIDE DATA

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  1. INFANT HOMICIDE DATA NAPHSIS / NCHS We measure babies. Our measurements measure us Michael Durfee MD

  2. My Background Child PsychiatristCareer – Child Abuse Neglect • Started Child Death Review 1978 • Projects today • Track neonates”at risk, substance abue” • California hospital discharge data - nonfatal review • Infant homicide data - Missing records

  3. Case Example of Child Abuse Data - single case Ten week old falls from couch to floor Taken to closest hospital in coma (in a neighboring state) And… dies

  4. 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)

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

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

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

  8. Vital Statistics + Child Abuse Data can assist each other • Public Health provide child abuse • Models for population study and surveillance • We can provide quality control • e.g. possible loss of infant homicide data

  9. LA County lost cases 1999-2006

  10. Potential explanations 1) Coroner record error (NO - mostly checked) 2) County of residence (NO - too many) 3) Children 1-17 (NO – see table/graph) 4 )Track individual cases 5) Other counties 6) Other states

  11. Cases “lost” by age and year

  12. Infants “lost” and 1-17 “OK”

  13. Next Check 4) Track individual cases 5) Other California Counties 6) Other States

  14. 4) Track cases - 24 in 2001Most validated by criminal court • 24 local to State first run =12, (To be repeated) • LA County Vital Stats 19 (“state index)” • State child death 6 – 10 (when E967 removed) • Summary, Needs to be repeated but all miss cases

  15. 5 Other Counties (California) • Sacramento 50% missing • Years 2003-2005 missing 9/18 • San Bernardino 63% missing • Years 2003-2006 missing 12 of 19 • Orange overall “even” ? • 2002 – 2006 miss 4 of 10, • 1999 - 2001 extra 4 out of 7

  16. 6 Other States/Counties • Some with small loss • Single county (Ohio, SC) and State of Missouri • Philadelphia County Pa. Missing 42% • 1999- 2005 missing 8 of 19 • Then I stopped, and came to this conference • All need to resolve this is…

  17. You! • Track Your • Infant Homicides • 1999 - 2007 • Coroner to Vital Stats • Email data to me or…

  18. History • 1860 – Ambrose Tardieu described fatal child abuse • And, almost nothing happened

  19. Current History of Child AbuseLiterature, laws, topics • 1965 “Child Abuse” to Index Medicus • 1990s fatal abuse in news and team review • 2000+ public health arrives

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

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

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

  23. 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

  24. Texas - Infant Death Data CPS (CACI) higher,as expected

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