Underascertainment of child abuse mortality in the United States.
Context Mortality figures in the United States are believed to underestimate the incidence of fatal child abuse.
Objectives To describe the true incidence of fatal child abuse, determine the proportion of child abuse deaths missed by the vital records system, and provide estimates of the extent of abuse homicides in young children.
Design and Setting Retrospective descriptive study of child abuse homicides that occurred over a 10-year period in North Carolina from 1985-1994.
Cases The Medical Examiner Information System was searched for all cases of children younger than 11 years classified with International Classification of Diseases, Ninth Revision codes E960 to E969 as the underlying cause of death and homicide as the manner of death.
A total of 273 cases were identified in the search and 259 cases were reviewed after exclusion of fetal deaths and deaths of children who were not residents of North Carolina.
Main Outcome Measure Child abuse homicide.
Results Of the 259 homicides, 220 (84.9%) were due to child abuse, 22 (8.5%) were not related to abuse, and the status of 17 (6.6%) could not be determined.
The rate of child abuse homicide increased from 1.5 per 100000 person-years in 1985 to 2.8 in 1994.
Of all 259 child homicides, the state vital records system underrecorded the coding of those due to battering or abuse by 58.7%. Black children were killed at 3 times the rate of white children (4.3 per 100 000 vs 1.3 per 100 000). (...)
Mots-clés Pascal : Enfant battu syndrome, Mortalité, Etats Unis, Amérique du Nord, Amérique, Incidence
Mots-clés Pascal anglais : Child abuse syndrome, Mortality, United States, North America, America, Incidence
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0437495
Code Inist : 002B18F02. Création : 22/03/2000.