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Child Fatality Review Panel Issues 10-Year Report

David Owens

December 14, 2011

In the past decade, the state Child Fatality Review Panel has investigated the deaths of 1,529 children.

On Wednesday, it issued a report on those deaths with recommendations it hopes will reduce the number of children who die each year.

Of those deaths, state Child Advocate Jeanne Milstein said, 840 were due to natural causes, such as disease or complications from premature birth. The remaining deaths, 689, were attributable to accidents, homicide, suicide and other causes and were preventable.

"Most of those are probably preventable," Milstein said. "We'll continue our efforts to reduce those numbers."

Milstein said public policy can reduce the number of child deaths. She said accidental deaths have declined in recent years, and she attributed the decline to fewer auto accidents involving teens. Fewer teens are driving because of stricter licensing laws for young drivers.

Similarly, efforts to educate parents about safe sleeping environments for young children have also helped reduce deaths, as have requirements that young children wear helmets when riding bikes, and laws requiring child restraint seats in cars, Milstein said.

Dr. H. Wayne Carver, the state's chief medical examiner and a panel member, said stricter driver laws for teens have saved lives. He termed the change "one of the greatest pieces of public policy I've seen in a long time."

Still, teen driving deaths remain a concern, according to the report. Of the 400 accidental deaths over the 10-year period, 214 were in motor vehicle crashes. Most of those children, 58 percent, were 16 or 17. Nine- to 15-year-olds accounted for 18 percent of the deaths.

Drowning accounted for 67, asphyxia 27, fires 20, and drug overdoses 19. The report said 53 deaths were attributable to a variety of causes, including falls, poisoning, checking, ATV crashes, gunshot wounds, falling objects and other causes.

"The message is safety — safety in all arenas," said Faith Vos Winkel, the assistant child advocate.

Accidental deaths are the second leading cause of death of children younger than 18. The leading cause of death each year is natural causes, such as disease and complications from premature birth. During the past decade, 840 children died of natural causes. Of those, 117 cases were classified as sudden infant death syndrome.

The report urges continuing efforts to teach parents and caregivers that the safest place for a infant to sleep is alone in a bassinet, crib or pack-and-play, with nothing else. Soft items such as pillows, blankets, stuffed animals and bumpers are a hazard.

Homicide, suicide and "undetermined" are the last three categories, and they change position each year.

Most homicide deaths are caused blunt force and head trauma in their homes, and the abuse is inflicted by a family member or friend. Gunshot and stabbing wounds account for 17 percent of homicide deaths.

To reduce the numbers, the panel recommends continued efforts to prevent child abuse, such as teaching parents about child development so that they understand why a child is crying, Vos Winkel said. She also urged daycare providers and pediatricians to ask questions about who is caring for children, and to ask questions.

Those most commonly responsible for blunt force trauma homicides were fathers, followed by boyfriends and ex-boyfriends of mothers.

Homicide is likely to occur before a child's first birthday, and then again when they are 16 and 17, according to the report. For the older children, the most common cause is gunshot or stab wounds, often inflicted after arguments or fights with people the victims knew.

"Our society has made a deal, perhaps a deal with the devil … that we accept a certain amount of gun culture, gun violence, and the cost of that is human life," Carver said. "I tend to look at firearms as a pathogen. The more there are in society, the more people get shot."

The panel recommended further efforts to help teens deal with anger, continued efforts to prevent abuse of infants reducing youths' access to weapons.

Suicide deaths have declined during the past decade, but Milstein expressed concern at five suicides reported since October. The report included statistics through July. Continued efforts to battle bullying, and educating people about suicide and what to look for are key, the panel said. Strong connections to family and friends, access to mental health support and limited access to weapons can help limit suicides, the panel said.