Preventable Child Mortality in Massachusetts State Child Fatality Review Team Legislative Briefing March 202
State Child Fatality Review Team Co-chaired by Chief Medical Examiner and Department of Public Health Medical Director Interagency and interdisciplinary representatives Local Child Fatality Review Teams Attorney General MA District Attorney Association State Police MA Chiefs of Police Association Executive Office of Public Safety and Security Department of Children and Families Department of Mental Health Department of Public Health Department of Elementary and Secondary Education Department of Developmental Services Department of Youth Services Office of the Child Advocate MA Chapter of the American Academy of Pediatrics MA Center for Sudden Infant Death Syndrome
Number of Deaths Magnitude and Trends in Deaths by Age Group, MA Residents, 0-7 Years, 2002-2009 700 600 500 400 300 200 630 N=630 N=629 N=607 N=588 N=567 543 5-7 0-4 5-9 -4 < 00 0 2002 2003 2004 2005 2006 2007 2008 2009 Year of Death The MA child death rate declined from 42.0 to 37.9 per 00,000* 2006-2008 Average Annual Death Rate per 00,000 US vs. MA: 6.2 vs. 40.6 Source: Registry of Vital Records and Statistics, MA Department of Public Health *not statistically significant
Rate per 00,000 MA Child Fatality Rates by Age Group, 2009 (N=543 Deaths) 500 450 400 350 300 250 200 50 00 50 0 474.2 3.9 7.9 23 under to 4 5 to 9 0 to 4 5 to 7 Age Group (Years) Source: Registry of Vital Records and Statistics, MA Department of Public Health
Rate per 00,000 Residents Child Fatality Rates by MA District of Residence, Ages 0-7 Years, 2009 (N=543) 75 50 25 23.6 * * 32.7 36.4 34.3 * 46.8 38.7 * 3.3 32 34 5.8 39. 37.9 0 Berkshire Bristol Cape and Islands Essex Hampden Middlesex Norfolk Northwest Plymouth Suffolk Worcester All Mass. District Source: Registry of Vital Records and Statistics, MDPH * indicates rates based on number <20 and is considered unstable.
Leading Causes of Death Among MA Children 0-7 Years, by Age Group, 2009 Rank < year -4 years 5-9 years 0-4 years 5-7 years All Children 0-7 years 2 3 4 5 6 7 8 Short gestation/lbw (83) Congenital malformations (57) SIDS/Signs and Symptoms (57) Maternal Pregnancy Complications (26) Complications of placenta, cord/membranes (5) Respiratory Distress (2) Bacterial Sepsis of Newborn (0) Neonatal Hemorrhage (9) 9 Necrotizing Enterocolitis (5) 0 Total Deaths All Causes Hematologic Disorders (5) Unintentional Injury (9) Cancer/In Situ Neoplasms (7) SIDS/Signs and Symptoms (4) Congenital Malformations (3) Heart Disease (2) Injuries of Undetermined Intent (2) Other Infections (2) Homicide () Influenza and Pneumonia () Cancer/InSitu Neoplasms (8) Congenital Malformations (4) Homicide (4) Unintentional Injury (3) Anemias (2) Heart Disease () Perinatal Conditions () Cancer (8) Unintentional Injury (5) Influenza and Pneumonia (4) Congenital Malformations (3) Heart Disease (3) Signs and Symptoms (2) Suicide (2) Injuries of Undetermined Intent () Medical Complication () Septicemia () Nephritis () Unintentional Injury (2) Homicide () Heart Disease (5) Suicide (5) Cancer (3) Congenital Malformations (3) Injuries of Undetermined Intent (2) Appendix Disease () Signs and Symptoms () Perinatal conditions (29) Congenital Malformations (70) SIDS/Signs and Symptoms (64) Unintentional Injuries (42) Cancer/In Situ Neoplasms (27) Homicide (7) Heart Disease (3) Injuries of Undetermined Intent (8) Suicide (7) Influenza and Pneumonia (5) 366 43 3 44 59 543 Data Source: Registry of Vital Records and Statistics, MA Department of Public Health
State Child Fatality Team Accomplishments Annual statewide conference Sudden unexplained infant death (SUID) investigation standardization improved data collection Standardized review guidelines Recent focus on key issues Safe sleep DPH revising its safe sleep policy for dissemination through all DPH programs and with sister agencies Drowning Window falls Coordination with DPH Infant Mortality Review Initiative
Rate per 00,000 Average Annual Unintentional Drowning Rates by Age Group, MA Residents 0-7 Years, 2004-2009 (N= 5) 3.5 3.0 N=5 2.5 2.0.5.0 0.5 N=3 N=8 N=6 N=0 N=4 0.0 < to 4 5 to 9 0 to 4 5 to 7 Total: 0-7 Years Age Group Source: Registry of Vital Records and Statistics, MDPH Rates based on numbers less than 20 are unstable. Rates not presented on counts <5.
Source of Water, Unintentional Drowning, MA Children 0-7 Years, 2004-2009 (N=5) Unspecified, 7, 4% Bath Tub, 6, 2% Other Specified, 4, 8% Natural Water, 2, 4% Swimming Pool, 3, 25% Source: Registry of Vital Records and Statistics, MA Department of Public Health
Percent of Total Unintentional Drowning by Water Source and Age Group, MA Children 0-7 Years, 2004-2009 (N= 5) 00% 3 2 75% 2 2 50% 3 8 2 5 0 Unspecified Other Specified Natural Water Swimming Pool Bathtub 25% 3 2 0% 2 < to 4 5 to 9 0 to 4 5 to 7 Age Group (Years) Source: Registry of Vital Records, MDPH
Our Goal - Reducing Preventable Child Deaths
Fatal and Nonfatal Injuries in Massachusetts Children and Youth
Annual Injury Deaths and Hospital Events for Nonfatal Injury, MA Residents 0-7 Years 76 Deaths (2009) 5,40 Hospital Stays (FY200) 64,233 Emergency Department Discharges (FY200) Sources: Registry of Vital Records and Statistics, MA Department of Public Health; MA Inpatient Hospital, Observation Stay and Emergency Department Discharge Databases, MA Division of Health Care Finance and Policy. All counts based on calendar year.
Percent reporting Percent of High School Students Reporting Never or Rarely Wearing a Seat Belt, MA vs. US, 2009 25 20 9.7 9 6.2 5 3.9.7 2. US 0 9.7 7 8.8 9.5 MA 5 0 Total Asian Black Hispanic White Race/Ethnicity Source: Youth Risk Behavior Surveillance System, National Center for Chronic Disease Prevention and Health Promotion. http://apps.nccd.cdc.gov/youthonline/app/default.aspx?sid=hs. Accessed /4/200