Fatal Abuse Essay, Research Paper

The undercounting is due in large part to inaccurate coding of deaths because of strict recording requirements that prevent statisticians at the state level from reporting deadly abuse without a prior history of such violence, experts say. The study is published in this week’s issue of the Journal of the American Medical Association. “Everyone in the field of child abuse has known this,” says Marcia Herman-Giddens, a child health expert at the University of North Carolina School of Public Health in Chapel Hill, and lead author of the study. “It’s such an unpleasant topic, people just want to avoid it.” Herman-Giddens, an official at the state medical examiner’s office at the time of the study, and her colleagues examined 259 cases of child homicide in victims age 11 or younger, between 1985 and 1994. Of those deaths, 220, or 85 percent, were attributed to child abuse or battery — about 59 percent more than had been previously recorded, the researchers claim. The study found that black children were about three times as likely as whites to suffer fatal child abuse. The typical perpetrator was a male parent, and parents of either sex were involved in about 63 percent of child murders, the report found. While child homicides are often well hidden by parents, the biggest problem that encourages underreporting is the system, says Herman-Giddens. Statisticians are forbidden by the International Classification of Diseases from calling a child murder abuse-related without evidence of earlier battery, she says. So, if a death certificate doesn’t report a child homicide as abuse at the hands of a parent, the incident gets lost when vital records are tabulated. Take, for example, a case in which a father stabs his infant to death. With no history of abuse, record keepers are forbidden from labeling the incident child abuse, she says. When correcting for the flawed recording, Herman-Giddens’ group found that the national figure of 2,900 abuse-related deaths involving children ages 9 or younger between 1985 and 1996, could in reality approach 9,500. The incidence of fatal child abuse has been rising in the United States over the last decade, up more than 12 percent a year in North Carolina, the researchers found. Homicide is the leading cause of injury death for babies in this country. Part of the increase, experts say, is likely because of more and more thorough investigations into child deaths. But part is also undoubtedly societal, the researchers say, a grim trend that must be reversed.

What’s also needed, says Herman-Giddens, is better training for medical examiners, their staffs, and the people who fill out death certificates so they can be more vigilant about recording cases of deadly child abuse. That way, she says, vital-records offices will be more likely to keep a good accounting of the number of such cases. Getting an accurate handle on the grisly figure is important, Herman-Giddens says, because it could help arouse public outrage about the problem of fatal child abuse. That, in turn, could produce bigger budgets for research into the area, and more government and private initiatives to help prevent abuse. “If you don’t have good data about a problem you can’t do much about it,” Herman-Giddens says. “We in the U.S. have no idea how many children are killed by their caretakers every year.” What To Do Kevin Kirkpatrick, a spokesman for Prevent Child Abuse America, says the Chicago-based group’s Healthy Families America program is a good model for how to reduce child abuse by reaching out to expecting and new parents. The program, which has 330 centers nationwide, offers home visits for parents seeking advice on how to do everything from change a diaper to arrange for immunizations. Begun in 1992, the initiative had served more than 200,000 people by 1997, says Kirkpatrick. More important, he says, early evidence suggests that the effort appears to be reducing the incidence of child abuse in participating families. To learn more about ways to prevent child abuse, or what to do if you suspect it’s occurring, visit Prevent Child Abuse America. Copyright 1999 Rx Remedy, Inc.Related Stories: Diving Shouldn’t Damage Your Brain Injuries said to result from not following rules When Passing Symptoms Warn of a Stroke Five factors identify high-risk patients TB Becoming Foreign Affair Rate is 5 times higher among immigrants News You Can Use Can Also Confuse Partial release of study results called risky Today’s Other Stories Cool Tools 7-Minute Checkup Sleep Calculator Prostate Check Look up a Drug Find a Doctor Eating Right? Check: Your Carbs Your Protein Your Cholesterol Encyclopedias: Medical Pediatric STD ——————————————————————————–