NORTH CAROLINA 2016 CHILD DEATH DATA

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1 NORTH CAROLINA 2016 CHILD DEATH DATA October 25, 2017 Kella Hatcher, Executive Director, NC Child Fatality Task Force Dr. Stephanie Watkins, MCH Epidemiologist, NC Division of Public Health

2 CFTF AND CHILD DEATH DATA CFTF mandate -- CFTF specifically charged with doing a statistical study of the incidences and causes of child deaths in NC [G.S. 7B-1403] Data drives action -- Data is one of the ways CFTF identifies issues that may require special focus from the CFTF Data source for most of this presentation: State Center for Health Statistics (SCHS) Note: The cause and manner of death determined by the Office of the Chief Medical Examiner (OCME) may be finalized or modified based on OCME review after the time period during which the SCHS finalizes annual data files, sometimes resulting in a slight variance with reported numbers between OCME and SCHS.

3 Deaths per 100,000 Resident Children NC Resident Child Death Rates (Ages 0-17) % DECREASE IN NORTH CAROLINA S CHILD DEATH RATE FROM Rate Source: NC State Center for Health Statistics

4 2016 RESIDENT CHILD DEATHS BY AGE GROUP 10 to 14 years, 7.90% 15 to 17 years, 12.30% 5 to 9 years, 6.40% 1 to 4 years, 9.30% Infants, 64.20% Source: NC DHHS North Carolina State Center for Health Statistics

5 Trends in North Carolina Resident Child Death Rates by Age Group, Ages Birth Through 17 Years Deaths per 100,000 Resident Children Ages % decline between for children 1-17 years TOTAL, AGES Ages Ages Ages Ages Ages (Exc. Infants) Ages Source: NC DHHS North Carolina State Center for Health Statistics

6 Trends in North Carolina Resident Child Death Rates by Race/Ethnicity, Ages Birth Through 17 Years Rate for African American is twice that of White Non Hispanics over time Deaths per 100,000 Resident Children African American rate in 2016 is 23% greater than White Non Hispanic rate in Total Non-Hispanic White Non-Hispanic Black/Af. Am Non-Hispanic American Indian Non-Hispanic Other Hispanic/Latino Source: NC DHHS North Carolina State Center for Health Statistics

7 Race/Ethnicity 2016 NC Child Death Rates by Race/Ethnicity HISPANIC 47.3 NON-HISPANIC OTHER 54.9 NON-HISPANIC AMERICAN INDIAN 62.5 NON-HISPANIC BLACK 95.2 NON-HISPANIC WHITE 46.6 TOTAL Deaths per 100,000 child residents ages 0-17 Source: NC DHHS North Carolina State Center for Health Statistics

8 LEADING CAUSES OF CHILD DEATH (AGES 0-17), NORTH CAROLINA RESIDENTS 2016 Cause of Death Total Deaths Perinatal Conditions 452 Illnesses 270 Birth Defects 204 Unintentional Injuries 201 Homicide 51 Suicide 44 All Other 138 TOTAL DEATHS 1,360 Source: NC DHHS North Carolina State Center for Health Statistics

9 NC 2016 CHILD RESIDENT DEATHS AGES 0-17 LEADING CAUSE OF CHILD DEATH All Other, 10.15% Suicide, 3.24% Homicide, 3.75% Perinatal Conditions, 33.24% Unintentional Injuries, 14.78% Birth Defects, 15.00% Illnesses, 19.85% Source: NC DHHS North Carolina State Center for Health Statistics

10 INFANT DEATHS Accounted for 64% of all child deaths in 2016 Perinatal conditions, illnesses, and birth defects are top causes Detailed infant mortality data addressed in separate presentation Detailed data also available here on the SCHS Website:

11 POLICY ACTION TO ADDRESS INFANT MORTALITY Ongoing: NC s Perinatal Health Strategic Plan ( Recurring funding in 2017 budget for You Quit 2 Quit perinatal tobacco cessation and prevention Pending: Study maternal and neonatal risk-appropriate care (HB 741, passed NC House) Pending: Add 3 conditions to newborn screening panel (HB 270=SB 190) Baby bundle funding stable per MCH Block Grant: MOD, Safe Sleep, 17P

12 2016 NC RESIDENT CHILD DEATHS AGES 0-17 BY TYPE OF UNINTENTIONAL INJURY Poisoning, 4.48% All Other, 13.93% Bicycle, 1.99% Drowning, 12.44% MVA, 50.75% Suffocation/choking/strangulation, 16.42%

13 POLICY ACTION ADDRESSING UNINTENTIONAL INJURY DEATHS Pending: close gap in the law related to restraint of rear seat passengers (HB 672) Civil enforcement of passing a stopped school bus -- automatic citations via bus cameras (SB 55 became law, now S.L ) HARMFUL SUBSTANCES INITIATIVE: Support for Operation Medicine Drop -- Safe Drug Disposal Strengthening of Controlled Substances Reporting System Improved accessibility for overdose reversal drug naloxone Strengthen impaired driving laws Stakeholder groups: Firearm Safety, Fatal Sports Injuries

14 2016 N.C. RESIDENT CHILD DEATHS DUE TO SUICIDE (TOTAL 44 DEATHS) By Age Group 10 to 14, 34.09% Other, 11.36% Poisoning, 2.27% By Means Firearm, 45.45% 15 to 17, 65.91% Hanging, 40.91% Source: NC DHHS North Carolina State Center for Health Statistics

15 2016 N.C. RESIDENT CHILD DEATHS DUE TO HOMICIDE (TOTAL = 51 DEATHS) By Age Group Infants, 15.69% Firearms were involved in 57% of child homicides 15 to 17, 41.18% 1 to 4, 21.57% 10 to 14, 7.84% 5 to 9, 13.73% Source: NC DHHS North Carolina State Center for Health Statistics

16 ACTION TO ADDRESS INTENTIONAL DEATHS Pending: required suicide prevention training for school personnel and risk referral protocol in schools (HB 285, HB 894) Recurring funding in 2017 budget for Child Medical Evaluation Program Examine Infant Safe Surrender laws; increase awareness Firearm Safety Stakeholder Group and CALM (Counseling on Access to Lethal Means) work group Examine data on child homicides, including maltreatment deaths

17 Trends in North Carolina Resident Child Death Rates for Selected Natural Causes of Death, Ages Birth Through 17 Years Deaths per 100,000 Resident Children Ages Birth Defects Perinatal Conditions Illnesses Motor Vehicle Accidents Other Accidents Homicide Suicide Source: NC DHHS North Carolina State Center for Health Statistics

18 Trends in NC Child Death Rates by Cause and Age Cause of Death Age Group Rate * Rate * Septicemia All Ages Unintentional Motor Vehicle Injuries Ages Other Unintentional Injuries Ages Unintentional Poisoning All Ages Percent Difference Other Unintentional Injuries Ages Homicide Infants Suicide All Ages * Rates are per 100,000 child residents

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20 2015 U.S. CHILD DEATH RANKINGS: AGES 0-17 Source: Centers for Disease Control and Prevention, National Center for Health Statistics Rank Residence Rate per 100,000 Population U.S. Total Rate Mississippi Louisiana South Dakota Alaska Alabama Arkansas North Dakota Georgia Delaware South Carolina Indiana West Virginia Kentucky Tennessee Missouri North Carolina 58.3

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22 2015 U.S. CHILD DEATH RANKINGS: AGES 1-17 Rank Residence Rate per 100,000 Population U.S. Total Rate Montana Mississippi Louisiana South Dakota Alaska West Virginia Indiana Tennessee Michigan Florida Kansas Iowa Utah North Dakota North Carolina 20.8 Source: Centers for Disease Control and Prevention, National Center for Health Statistics

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25 SOCIAL DETERMINANTS OF HEALTH (SDH) SDH = the structural determinants and conditions in which people are born, grow, live, work and age A meta-analysis of nearly 50 studies found that social factors, including education, racial segregation, social supports, and poverty accounted for over a third of total deaths in the U.S. in a year [Source: Kaiser Family Foundation Issue Brief, Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity, Nov. 4, 2015]

26 QUESTIONS?