NUMBERS AND TRENDS | MARCH 2021 Child Abuse and Neglect Fatalities 2019: Statistics and Interventions Despite the efforts of the child protection WHAT'S INSIDE system, child maltreatment fatalities remain a serious problem.1 Although the untimely How many children die each year from child deaths of children due to illness and accidents abuse or neglect? are closely monitored, deaths that result from physical abuse or severe neglect can be more What groups of children are most vulnerable? difficult to track. This factsheet describes data on child fatalities and how communities can How do these deaths occur? respond to this critical issue and, ultimately, prevent these deaths. Who are the perpetrators? 1 This factsheet provides information regarding child deaths resulting from abuse or neglect by a parent or a How do communities respond to child primary caregiver. Other child homicides, such as those committed by acquaintances and strangers, and other fatalities? causes of death, such as unintentional injuries, are not discussed here. For information about leading causes of child deaths nationally from 1999 to 2019, visit the How can these fatalities be prevented? Centers for Disease Control and Prevention website. Statistics on child homicide from 1980 to 2011 can be obtained from the U.S. Department of Justice. Summary Additional resources References Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 1 5 children dying every day from abuse or neglect. NCANDS defines “child fatality” as the Unless otherwise noted, statistics in this death of a child caused by an injury resulting factsheet are taken from the Children’s from abuse or neglect or where abuse or Bureau’s Child Maltreatment 2019 report neglect was a contributing factor. and refer to Federal fiscal year (FFY) 2019. Statistics refer to the year in which The number and rate of fatalities reported by States have fluctuated during the past 5 years. the deaths were determined to be from The national estimate is influenced by which maltreatment; in some cases, this may States report data as well as by the U.S. have been different from the year in which Census Bureau’s child population estimates. a child actually died. Some States that reported an increase in child fatalities from 2012 to 2013 attributed it to improvements in reporting after the passage HOW MANY CHILDREN DIE EACH of the Child and Family Services Improvement YEAR FROM CHILD ABUSE OR and Innovation Act (P.L. 112–34), which passed NEGLECT? in 2010. According to data from the National Child Abuse and Neglect Data System (NCANDS), 51 States2 reported a total of 1,809 fatalities.3 Fatalities er Year Based on these data, a nationally estimated 1,840 children died from abuse or neglect in 1,660 FFY 2019, a slight increase from the FFY 2018 201 number of 1,780. However, it is a 10.8-percent increase over the FFY 2015 number of 1,660. 201 1,730 1,840 201 1,710 children 201 1,780 An estimated 1,840 children died due to abuse or neglect in FFY 2019. 2019 1,840 The FFY 2019 data translate to a rate of 2.5 children per 100,000 children in the general population and an average of more than 2 In the context of NCANDS, the term “States” includes the 50 States, the District of Columbia, and the Commonwealth of Puerto Rico. 3 The Children’s Bureau received data from 51 States. Of those States, 45 reported case-level data on 1,515 fatalities, and 34 States reported aggregate data on 294 fatalities. Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 2 Most data on child fatalities come from Limited coding options for child deaths, State child welfare agencies. However, especially those due to neglect or States may also draw on other data sources, negligence, when using the International including health departments, vital statistics Classification of Diseases to code departments, medical examiners’ offices, death certificates law enforcement, and fatality review The ease with which the circumstances teams. This coordination of data collection surrounding many child maltreatment contributes to better estimates. deaths can be concealed or rendered Many researchers and practitioners believe unclear that child fatalities due to abuse and neglect Lack of coordination or cooperation among are underreported (Schnitzer et al., 2013). different agencies and jurisdictions The following issues affect the accuracy and Several organizations have suggested consistency of child fatality data: practices at the Federal, State, and local levels Variation among reporting requirements that could improve data reporting and result and definitions of child abuse and neglect in a more accurate count of maltreatment and other terms deaths. A report by the Federal Commission to Eliminate Child Abuse and Neglect Fatalities Variation in death investigation systems (2016) suggests enhancing the ability of and training national and local systems to share child Variation in State child fatality review and fatality data so that agencies can use lessons reporting processes learned to prevent future deaths. In a May The length of time (up to a year in some 2019 report, the National Center for Fatality cases) it may take to establish abuse or Review and Prevention (NCFRP) suggests neglect as the cause of death that standard protocols and minimum data Inaccurate determination of the manner sets be established for child death review and cause of death, which results in the (CDR) and fetal and infant mortality review miscoding of death certificates and includes teams. NCFRP also provides suggestions deaths labeled as accidents, sudden for improving child welfare reviews in a infant death syndrome, or undetermined September 2018 report. that would have been attributed to abuse or neglect if more comprehensive investigations had been conducted Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 3 WHAT GROUPS OF CHILDREN HOW DO THESE DEATHS ARE MOST VULNERABLE? OCCUR? Almost three-quarters (70.3 percent) of Fatal child abuse may involve repeated child fatalities in FFY 2019 involved children abuse over a period of time, or it may younger than 3 years, and children younger involve a single, impulsive incident (e.g., than 1 year accounted for 45.4 percent of drowning, suffocating, shaking a baby). all fatalities. See figure 1 for additional In cases of fatal neglect, the child’s death data about the age of fatality victims. does not result from anything the caregiver Young children are the most vulnerable does; rather, it results from a caregiver’s for many reasons, including their failure to act. The neglect may be chronic dependency, small size, and inability to (e.g., extended malnourishment) or acute defend themselves. (e.g., an infant who drowns after being left unsupervised in the bathtub). FIGURE 1. CHILD ABUSE AND NEGLECT FATALITY VICTIMS BY AGE, 2019 30.9% 1 to 3 years 11.2% 4 to 7 years 4.7% 12 to 15 years 5.6% 8 to 11 years 2.0% 16 and 17 years 0.2% Unborn, unknown, and ages 45.4% 18 to 21 years Younger than 1 year Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 4 In 2019, 72.9 percent of children who died Medical neglect either alone or in from child maltreatment suffered neglect combination with another maltreatment either alone or in combination with another type was reported in 7.8 percent of fatalities. maltreatment type, and 44.4 percent of See figure 2 for additional information about children who died suffered physical abuse fatalities by maltreatment type. either alone or in combination with other maltreatment. WHO ARE THE PERPETRATORS? In 2019, parents—acting alone or with another parent or individual—were responsible for 79.7 percent of child abuse or neglect fatalities. 72.9% More than one-quarter (29.2 percent) of In FFY 2019, 72.9 percent of children fatalities were perpetrated by the mother who died from child maltreatment acting alone, 14.2 percent were perpetrated suffered neglect either alone or by the father acting alone, and 22.6 percent in combination with another were perpetrated by two parents of known maltreatment type. sex4 acting together. Nonparents (including kin and child care providers, among others) FIGURE 2. CHILD ABUSE AND NEGLECT FATALITIES BY REPORTED MALTREATMENT TYPE, 2019 80 70 60 50 40 30 20 10 0 72.9% 44.4% 7.8% 0.9% 0.9% 7.9% Neglect Physical Medical Sexual Psychological Other abuse neglect abuse abuse Note: The total of the percentages exceeds 100 percent because fatalities may involve more than one type of maltreatment. 4 The “two parents of known sex” category replaces the “mother and father” category and includes mother and father, two mothers, and two fathers. Children’s Bureau/ACYF/ACF/HHS | 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov 5 were responsible for 16.6 percent of child fatalities, To address some of these issues, multidisciplinary and child fatalities with unknown perpetrator and multiagency child fatality review teams have relationship data accounted for 3.7 percent of the emerged to provide a coordinated approach to total. For more information, see figure 3. understanding child deaths, including deaths caused by religion-based medical neglect. HOW DO COMMUNITIES RESPOND The development of these teams was further TO CHILD FATALITIES? supported in an amendment to the 1992 reauthorization of the Child Abuse Prevention and The response to child abuse and neglect fatalities Treatment Act (CAPTA), which required States to is often hampered by inconsistencies and other include information on CDR in their program plans.