Do "Accidents" Happen? An Examination of Injury Mortality Among Maltreated Children
Date
2010
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University of California Berkeley
Abstract
This dissertation is based on a unique dataset constructed by probabilistically linking records across three independent sources of data from California: 1) vital birth records, 2) administrative child protective service records, and 3) vital death records. The final dataset captures 4.3 million children born in California between 1999 - 2006 and includes maltreatment allegation information for over 500,000 children who were reported to child protective services (CPS), as well as death reports on 2,000 children who were fatally injured before age five. This study represents the most rigorous longitudinal analysis of mortality outcomes following a report to CPS to date, with several key implications for practice and policy emerging. First, these data underscore that a child's report to CPS is not random, nor is it simply a function of poverty. Rather, a report to CPS signals a level of risk, including a risk of death, that is greater than sociodemographic factors would alone predict. A second and related point is that children evaluated out after a CPS hotline call reflect a group whose risk of injury death is far greater than their unreported sociodemographic peers. The decision to screen these children out without an investigation, under the logic that these children were assessed to be at no greater risk of harm than other demographically similar children, is not supported by the empirical evidence generated from this study. Third, these data highlight that although there has been a recent emphasis on the unmet service needs of children reported for neglect, it is young children reported for physical abuse who face the greatest risk of death. Given that physical abuse allegations represent a minority of reports received by CPS, these data suggest that a different protocol for investigating and intervening in cases in which physical abuse is alleged may be justified. Finally, the finding that a prior allegation of maltreatment is the single greatest predictor of not just intentional injury death, but also unintentional injury death, lends support to calls that have been made for child welfare services to be pursued under a broader, public health-oriented agenda, focused on the prevention of all manners of injury death. (Author Abstract)
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Keywords
child abuse, physical abuse, child protective services, fatality, research
Citation
Hornstein, E. P. (2010). Do" Accidents" Happen? An Examination of Injury Mortality Among Maltreated Children. (PhD Dissertation). Berkeley, CA: University of California Berkeley. (Fall 2010), 125 p.