1. Suspicious Infant Death A Proposed National Data Set Michael Durfee MD APHA 2004

2. Based on Data Match X3+ and… “LA Model” Data Match X3+ –1 FBI UCR SHR (Cop Homicide) –2 Vital Statistics (Coroner Homicide) –3 Child Abuse Central Index (CPS) –+ Child Death Review Team LA Model – infants only (from above)

4. Matching Data Sets Connect…` Professions – –Justice –Health –CPS More powerful data State/local agencies

5. Case Example of Data Match Resolves the “Puzzle” Ten week old falls from couch to floor Taken to closest hospital in coma (in a neighboring state) And… dies

6. FBI UCR SHR - Dad suspect (Local Police) Coroner- Undetermined (neighboring state) Child Abuse Central Index, No Report (Local CPS) Suspicious Death (local Child Death Review Team)

7. Team finds Coroner In neighboring state Tell law enforcement `

8. Dad convicted but no one reports to social services Three siblings left in home

9. Matching data sets identifies missing records Siblings found and served

11. Why Only Infant Cases Manageable with present resources –<12 cases/year for most states –existing data (X3) –Avoid Extra Codes Infant homicides are significant –95%+ by caretaker –40% of all caretaker homicide –Problem cases for adult oriented systems

12. Studies - Single Data Sets

13. State Infant Homicide Rates Vary up to 400%

14. State Infant Homicide Rates Correlate with… Infant mortality rates –Pearson r = 0.79 with p <0.0001 Quality of investigation –Missouri has systematic investigation –LA County changed cases to homicide

15. Infant Rates Constant/Time (Differ from older homicide)

16. Homicide by Age/Gender (Younger victim about equal)

17. Homicide /Rate /Age /Race (Rates for all ages, not equal)

18. Match Infant Data X3 (ican-ncfr.org)

19. Texas - Suspicious Infant Death Rate/Year (X3) (CPS cases higher – expected)

20. California Infant Homicide Rate/Year (CPS low - missed data entries)

21. DOJ Homicide N=243 VS Injury Deaths N=1165 VS Homicide N=214 VS CAN N=90 DOJ CAN N=196 DOJ CACI N=128 N=56 Child Abuse and Neglect Fatalities: Children < 6 Years, California 1992-3

22. LA MODEL CASE DATA MATCH

23. LA Model Sample Case 3 month male father threw against wall “Manner” of death X3 –Homicide (UCR and VS) no record CPS Action –Father convicted –Case reported to CACI –CPS records found in two counties Counties meet to share data Siblings located, with mom, voluntary services

24. National Infant Data X3+ National data with common language –Teams could compare data and cases (e.g., State infant homicide rates) –Connect cases across state/county lines Support more complex data systems –CDC National Violent Death Child death indices

25. Resources Web Site - ican-ncfr.org –Team Reports –“51 State” Comparison –Infant Data x3 / State –LA Model – 2005 APHA Caucus on Family Violence –Michaeld55@aol.comaeld55aeld55