Building a National Strategy to End Child Abuse and Neglect Deaths | Commentary

Posted September 8, 2014 at 4:05pm

Each year, more than 1,500 children across the country die as a result of abuse and neglect. This month, the U.S. Commission to Eliminate Child Abuse and Neglect Fatalities met in Detroit as part of a multi-state fact-finding mission to develop a national strategy for reducing these tragedies.

The commission, established by Congress through the “Protect Our Kids Act of 2012,” is charged with studying the scope of the problem, identifying what works to protect these kids, and reviewing the impact of current federal and state policy and funding on this problem.

The issue is complex, and it impacts every neighborhood, every community, and every state in our nation. According to the U.S. Department of Health and Human Services — the official source of data on this issue — more than 15,000 children died from abuse or neglect between 2001 and 2010; 285 of those deaths occurred in Michigan.

Increasingly, we are learning that these figures, as terrible as they are, may not provide a complete understanding of how many children in the United States die every year due to abuse and neglect.

There are many reasons for this. Federal data are derived from a database that is in turn based on reports from each state’s child protective services agency. Relying on data from child welfare agencies alone to count child abuse and neglect fatalities has limitations, since not every death from child abuse or neglect is reported to the child welfare system. Also, even though fatalities are reported to child welfare agencies, some deaths may not be identified as being the result of child abuse or neglect.

Additionally, when data from other sources is provided to child welfare agencies voluntarily, it’s not without problems. Such other major data sources — child death certificates, law enforcement data, and data collected by teams that review child deaths — have their own set of problems, due to a lack of consistency in when a death is attributed to abuse and neglect. Doctors, coroners, medical examiners and law enforcement professionals are often not trained to recognize child abuse and neglect, so deaths due to abuse and neglect might not be recognized as such. State child death review programs often do not review all child deaths.

Even when all the data are available, experts in many states may not agree on whether a given death is the result of abuse or neglect. For example, if a 2-year-old dies in a swimming pool, is it neglect if the child was left alone for 2 minutes? 10 minutes? An hour? Does it matter if Child Protective Services had been previously involved with the family? What if the parents had a few drinks the afternoon of the death? Where do we draw the line between an accident and neglect?

To address these problems, Michigan has developed a multi-agency process to identify, count, and report on child abuse fatalities. Our Department of Human Services, led by Director Maura Corrigan, funds the Michigan Child Death Review Program and Citizen Review Panel on Child Fatalities. Together with the Michigan Public Health Institute, these institutions review the circumstances of all child deaths statewide and submit comprehensive case reports that are then forwarded to the national database.

Michigan also has a state level advisory panel on child deaths, which determines how these tragedies can be avoided in the future. This panel focuses on identifying systemic problems that may result in child fatalities, and makes recommendations to prevent child abuse and neglect fatalities in the future. In 2012,this group released a four-year strategy to reduce infant mortality, including by focusing on a statewide safe sleeping program and expanded home visiting programs.

The work we have done and continue to do in Michigan is rightly being studied by the national commission as it researches this issue and hears from stakeholders from child welfare and child protective services, law enforcement, public health, domestic violence, mental health, health care, judiciary, district attorneys, researchers and educators, as well as advocates, parents and youth.

Our hope is that by working together with those charged with protecting vulnerable children, we can better understand how to prevent child fatalities from maltreatment and ultimately build a national strategy to safeguard children from this terrible fate.

Rep. Dave Camp, a Republican from Midland, represents Michigan’s 4th District and is the chairman of the House Ways and Means Committee. Rep. Sander M. Levin, a Democrat from Royal Oak, represents Michigan’s 9th District and is a ranking member of the House Ways and Means Committee.