Characteristics of child abuse fatalities: Insights from a statewide violent death reporting system

Abstract

Background: Child maltreatment fatalities are a significant public health issue. Case level characteristics of abuse-related deaths can increase our understanding of maltreatment fatalities and inform region-specific prevention initiatives.

Objective: Explore child abuse fatalities in the Illinois Violent Death Reporting System (IVDRS) for commonalities and distinctive features.

Methods, participants and setting: A mixed methods study was conducted using IVDRS data from 2015 to 2018. All fatalities with a homicide or undetermined manner of death among decedents 10 years old or younger were included. Both discrete and narrative data were analyzed separately for victim, suspect, circumstance, and household characteristics.

Results: Of the 106 deaths that met inclusion criteria, 74 % of homicide deaths (64/86) and 50 % of undetermined deaths (10/20) were due to abuse. Psychosocial characteristics most often identified in abusive deaths included family relationship problems, mental illness, and history of substance abuse. Other common characteristics included use of personal weapons or blunt instruments and death due to punishment. Including narrative data rather than discrete data alone identified 148 % more deaths with three characteristics commonly found in abusive deaths: history of abuse, shaken baby syndrome, and family history of violence.

Conclusion: This study demonstrates the capability of multi-source state-level data to enrich our understanding of child abuse fatalities. Employing the narrative review method in other states using the National Violent Death Reporting System may increase the identification of abuse fatalities. Improved recognition and characterization of abuse fatalities has the potential to help address systemic factors involved and enhance targeted prevention efforts.

What is known: Child abuse fatalities represent a significant and preventable public health issue in the United States. Case-specific characteristics are limited in national data sets, and their absence curtails prevention opportunities.

What this study adds: State-wide reporting systems of violent deaths offer rich and multisource data regarding child abuse fatalities including detailed victim, suspect, circumstance, and household characteristics. This data can be used to enhance our knowledge of maltreatment fatalities and may inform region-specific public health and prevention initiatives.

Keywords: Child fatality; Child homicide; Child maltreatment; Psychosocial risk factors.