Peer-reviewed article
Child Fatality Individual Case Reports: A 24‐Year National State‐by‐State Review
David Mark Mantell, Natalie Chong, Todd Takeno, Michelle Pazdur, Taylor Walker ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined 1,186 child fatality review board case reports from six U.S. states over 24 years to understand causes of child deaths from neglect and injury. The researchers found that only 2% of publicly available reports contained sufficient information about key causative factors like cause of death, prior child protection involvement, professional errors, and at-risk family circumstances. The study reveals major gaps in how states document and report child fatality cases.
Key points
- Only 25 of 1,186 reports (2%) contained adequate information on all four major causative factors
- Data collection comes from six states over a 24-year period (1995-2019)
- Key missing factors included: cause of death, prior child protection agency involvement, evidence of professional negligence, and family history of at-risk circumstances
- Study identifies need for federal guidelines on case tracking, standardized terminology, and common reporting procedures
- A robust national database is needed to better understand child fatality patterns
Limitations
The study is limited to reports from only six of 50 states, which may not represent national patterns. The analysis focuses on what information is publicly available in reports rather than what information exists but is not disclosed, so it cannot fully explain why data are missing.
Abstract
Abstract This study focused on the content of 1186 Child Fatality Review Board individual case reports collected nationally over a 24‐year period (1995–2019). This information, in contrast to group data, may yield important insights into the causative factors, especially for child fatality resulting from neglect and inflicted injury. The reports were collected from six of the 50 states and evaluated for the quality and amount of information. They were also surveyed for data identifying causative factors for neglect and inflicted injury. Only 25 (2 per cent) of 1186 reports that are publicly available contained sufficient information about the four major causative factors—cause of death, prior child protection agency involvement by the family, evidence of professional negligence or error and family history of at‐risk circumstances. The 25 cases were then reviewed and coded for presence of information about these factors. The findings demonstrate the need for federal intervention to provide specific guidelines for the states to track their cases, to use a common nomenclature, to investigate common causative factors and to practice common reporting procedures. In this way, a robust national database can be developed.