Within Our Reach

Preventing Child Fatalities is Possible and Indiana is Leading the Way

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October 10, 2022

By: Susana Mariscal and Bryan Victor

There is a shift taking place across the nation regarding child abuse and neglect fatalities. These heartbreaking tragedies make headlines across every community, with a focus on why systems failed our children and how these children fell through the cracks.

As the U.S. Commission to Eliminate Child Abuse and Neglect Fatalities notes, child welfare systems have historically been focused on addressing harm only after it has occurred. Fortunately, federal and state agencies along with local nonprofits and community leaders are beginning to work collaboratively and create a multi-system service continuum to provide the resources that families need beforehand, preventing abuse and neglect before it occurs. We can see evidence of that shift, with demonstration projects across the U.S., including Indiana, that are identifying risk factors (e.g., contributing factors) for child fatalities, moving resources upstream to support families, and building on protective factors with an emphasis on prevention.

The Indiana Department of Health (IDOH) is one of five sites nationwide participating in a Department of Justice demonstration initiative known as Child Safety Forward (CSF). With support from technical assistance providers and multidisciplinary child fatality review teams, IDOH has conducted research focusing on Clark, Delaware, Grant, and Madison counties that identified unsafe sleep-related deaths as the leading cause of death due to external causes (e.g., sleep-related, drowning) for children ages 0-18 years old, excluding medical reasons. The findings from IDOH – based on a 5-year retrospective review – highlighted that Black infants are at a heightened risk for sleep-related deaths (55.9%t; 19 of 34 deaths) and that sleep-related deaths have been underreported throughout the state due to inconsistent and incomplete documentation of Sudden Unexpected Infant Deaths (SUIDs). High quality, accurate fatality data enables jurisdictions to better understand and address risk factors, improving the effectiveness and actionability of recommendations.

Based on these findings, IDOH took several steps to expand the state’s ability to prevent child fatalities. They developed Community Action Teams to implement prevention initiatives, and are working collaboratively with Prevent Child Abuse Indiana chapters and Family Resource Centers run by the Strengthening Indiana Families project to educate the public about safe sleep practices. Family Resource Centers are a one-stop-shop for families, providing tailored resources to address their needs and build on their strengths. IDOH has also developed videos providing safe sleep information and stories of parents who lost a child in unsafe sleep environments. (For more information on safe sleep, visit the IDOH website.)

Informed by findings from the CSF initiative, Indiana legislators passed House Enrolled Act 1169 — which went into effect on July 1, 2022 — establishing consistent standards for SUID investigations and data collection, aligning with the Centers for Disease Control and Prevention best practices, including pathology and toxicology.

It is important to note that, in 2020, in 95 of 168 cases identified (56.5 percent), children were unknown to Child Protective Services before the fatality, indicating that government agencies like the Indiana Department of Child Services alone cannot prevent these deaths. The work of fatality prevention lies with all of us: neighbors, community members, and the full range of professionals that serve children and families. To increase our effectiveness at preventing these fatalities and reducing racial disparities, the multiple systems that serve families must collaborate and share information to provide coordinated, holistic services. Communities also need to increase their formal and informal supports for families, so that all parents in the community have equitable access to the resources they need to be connected and safe. Every parent needs help at some point and -as the Family Resource Centers’ motto says- “Kids don’t come with instructions. We’re here to help.” Let’s all join in the nationwide shift toward prevention by supporting families in our communities so that children can develop their full potential. Imagine what a difference we all can make in the lives of children in our community when we work together proactively to keep the most vulnerable among us safe.

A version of this article appeared previously in the Indianapolis Star on October 6, 2022.

Disclaimer: This product was supported by cooperative agreement number 2019-V3-GX-K005 Reducing Child Fatalities and Recurring Injuries Caused by Crime Victimization, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice and by the Children’s Bureau, Administration for Children, Youth and Families, Administration for Children and Families, USDHHS, under grant 90CA1864. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice and the Children’s Bureau.

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