Do prior maltreatment reports serve as a risk factor for child fatalities?

RESEARCH FROM THE FIELD

JOURNAL ARTICLE SUMMARY

Do prior maltreatment reports serve as a risk factor for child fatalities?

Putnam-Hornstein, E. (2011). Report of maltreatment as a risk factor for injury death. Child Maltreatment, 16(3), 163-174. 

What can we learn from this study?

Young children under age 5 who are involved in a report of maltreatment are particularly vulnerable to extreme physical abuse and intentional fatal injuries, as well as unintentional injuries. This study examines whether there is a correlation between the presence of a nonfatal maltreatment allegation and child fatalities (both intentional and unintentional) in young children.

Study details:

  • Population: 4.3 million children born in California
  • Data source: Vital birth records; administrative CPS records; and vital death records
  • Methodology: Probabilistic linkage methodology; Extended Cox Regression models

What are the critical findings?

After controlling for sociodemographic characteristics that may be associated with child maltreatment (child sex, child race/ethnicity, presence of a child health risk, birth order, maternal age, maternal education, insurance type, and whether paternity was established on the birth certificate), this study found that a prior allegation to CPS was the strongest risk factor for injury mortality before age 5.

  • Overall, children with a prior allegation of abuse or neglect were fatally injured at a rate that was more than 2.5 times that of children without a prior allegation.
    • Children with a previous maltreatment allegation died from intentional injuries at a rate over 5.9 times that of children without a previous maltreatment allegation.
    • Children with a previous maltreatment allegation died from unintentional injuries at a rate twice as high as children without a previous maltreatment allegation.
  • One in five children (20%) who died of injuries had been previously reported to CPS.
    • When only intentional injury deaths were considered the rate rose to one-third (33%).
    • Over half (51.4%) of children under age five who died from a fatal injury had a prior non-fatal CPS allegation or died under circumstances suspicious enough to warrant a report on the date of their fatal injury or after the child’s death.

Why is this important for our work?

These findings indicate the need for more widespread public health prevention campaigns and targeted interventions for families that have been reported to CPS.

This summary synthesizes the findings from a single research study. To learn more about the preventing child fatalities, please review the following resources: How did NYC implement the Safe Sleep Initiative to reduce child fatalities? and If I knew then what I know now: Seven strategies to reduce child abuse and neglect fatalities.

For additional information, access the article directly or email KMResources@casey.org.