south carolina child death fatalities
DESCRIPTION
H. Gratin Smith, MDTRANSCRIPT
UPDATE FROM THE SC CHILD FATALITY ADVISORY COMMITTEE
H. Gratin Smith, MDSeptember 11, 2013
Why Does Child Death Review Matter?
Helps to identify trends on a statewide scale Allows for comparison to other states Helps to make sure deaths are accurately
classified to make meaningful analysis possible
Allows for more informed suggestions for change
The CDC has determined that the multidisciplinary approach now in place is the most effective way to help decrease child deaths
An Overview
What is the SC Child Fatality Advisory Committee?
What does the committee do? What are the recent trends and
findings noted by the committee, and what are their recommendations?
Formation of the SC CFAC
In 1993 legislation mandated (but did not provide for funding of) the formation of the State Child Fatality Advisory Committee to identify patterns in child fatalities.
An annual report is produced. This information is to be used by communities, individuals and agencies to decrease the number of preventable child deaths in our state.
The report can be viewed at SC DHEC’s website.
Deaths Reviewed by the SC CFAC The death of any child (<18) that is
unexpected, suspicious, unexplained or occurs when the child is NOT under the direct care of a physician. This includes, but is not limited to SIDS cases.
Traffic/highway deaths are not reviewed by the SC CFAC (unless they occur on private property). They are reviewed by the DMV.
Makeup of the SC CFAC
Members are appointed by the governor after recommendation from the specific state agencies or the committee.
Members of the SC CFAC as specified in the legislation forming the committee
DHEC DDSN SCDE SLED SCAAP-Pediatrician A forensic pathologist SC Criminal Justice
Academy
DSS DYS SC Commission on
Alcohol and Drug Abuse SC Coroner Solicitor SCDMH 2 Child Advocates
SC CFAC Meetings
Full day every other month Guest presenters Reports from members Review @ 40 cases per meeting
during executive session (closed to public). (@ 200-250 cases are reviewed every year)
The Process of Child Death Review A child death occurs Coroner is notified Coroner notifies SLED within 48 hours Case is assigned to an agent Agent gets details, medical records,
DSS notes, LE notes Case report is “completed” by the
agent Case goes to CFAC
What Does the CFAC Actually Do? Case reports are sent to members
before the meeting Agencies involved report on their
involvement with the case Medical aspects of the case are
reviewed The committee tries to determine
how the death may have been prevented by looking at SYSTEMS ISSUES
What Does the CFAC NOT DO? The committee’s function is not to
investigate or solve crimes The goal is not to criticize, but to
offer suggestions for improvement by analyzing system failures.
Recent Findings of the SC CFAC Reviews
The cases are categorized based on the year that they occurred.
The most recent annual review that has been completed is 2009. There were 189 deaths in 2009 that were reviewed.
The statistics in this presentation are from cases that met the definition for review by the SCFAC (not the total number of child deaths in the state)
SC Statistics
Population about 4.5 million Population < 18 y.o. (23%) about
1,035,000 White citizens 66.2% Black citizens 27.9% 17% of citizens below the poverty
level Per cent of 8th graders to graduate-
75% @ 25% of babies born to single
mothers
2009 SC Child Fatalities by Race
81
84
135
2
4
White BlackHispanicBiracialAsian Unknown
2009 SC Child Fatalities by Gender
58%
42%malefemale
Manner of Death Categories For every death there is an assigned
cause of death (very many) and one of 5 “manners of death”
Natural Accidental/Unintentional Injury Homicide Suicide Undetermined
2009 Manner of Child Death by Category
Accident Natural Homicide Undet Pending Suicide0%
5%
10%
15%
20%
25%
30%
35%
40%
Accidental Child Deaths in SC 1993-2009
93 94 95 96 97 98 9920
00 01 02 03 04 05 06 07 08 090
20
40
60
80
100
120
2009 SC Accidental Child Deaths
26
19
13
5
3 2 1
AsphyxiaDrowningFireShootingOverdoseVehicularPoisoning
2009 SC Accidental Child Deaths by Age
<1 y.o. 1-4 y.o. 5-9 y.o. 10-14 y.o. 15-17 y.o.0
5
10
15
20
25
30
2009 SC Accidental Child Deaths by Gender
male female0
5
10
15
20
25
30
35
40
45
50
2009 SC Child Drowning Deaths by Age
1-4 y.o. 5-9 y.o. 10-14 y.o. 15-17 y.o.0
1
2
3
4
5
6
7
8
9
2009 SC Child Drowning Deaths by Gender
Male Female0
2
4
6
8
10
12
14
2009 SC Child Fire Deaths by Race
75
1
BlackOtherWhite
2009 SC Child Fire Deaths by Home Structure Type
MobileStick Built
2009 SC Child Fire Deaths by Age
<1 yr 1-4 yrs 5-9 yrs 10-14 yrs 15-170
1
2
3
4
5
6
7
8
In 2009, Five SC Children Died of Accidental Gunshot Wounds
5-9 y.o. 10-14 y.o. 15-17 y.o.0
0.5
1
1.5
2
2.5
In 2009, Two SC Children Died in ATV (4 Wheeler) Accidents
SIDS/SUDI/SUID Cases in SC 1993-2009
93 94 95 96 97 98 9920
0020
01 02 03 04 05 06 07 08 090
10
20
30
40
50
60
70
80
1993-2009 Child Homicide Deaths in SC
93 94 95 96 97 98 9920
00 01 02 03 04 05 06 07 08 090
5
10
15
20
25
30
35
40
45
2009 SC Child Homicide Deaths by Age
<1 y.o. 1-4 y.o. 5-9 y.o. 10-14 y.o. 15-170
2
4
6
8
10
12
14
Perpetrators of Fatal Child Abuse and Neglect in SC 2009
4
4
3
2
1
1
11
17 cases
Mom's BFFatherStrangerUncle MotherStepmomSiblingOther
2009 SC Fatal Child Abuse and Neglect by Category
4
2
8
11
AbusHd TrAsphyxiaBeatingHead TrMalnutrit
Some SC Counties With High Numbers of Child Fatalities 2009 (#), rate (#/100,000)
Sptnbrg (26) 35
Richland (21) 24
Anderson (5) 11.3
Beaufort (7) 21.5
York (7) 12.3
Charleston (16) 22.2
Berkley (6) 13.7
Darlington (6) 37
Greenville (14) 13
Horry (7) 13
Lexington (22) 35
2009 SC Child Suicides, # 8
Males #4 Females #4 10-14 y.o. #2 15-17 y.o. #6 Shooting #2 Hanging #6
Trends Noted by the SC CFAC There are an alarming number of child
deaths involving 4-wheelers Child deaths in fires are much more
common in mobile homes In fire death cases, the absence of
functioning smoke alarms is often noted in the reports
Most sleep related deaths involve some practice recognized as an unsafe sleeping situation