University of Missouri - Columbia.
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Posted 11.07.05

Risk of Inflicted Injury Death is High for Children Living with Unrelated Adults, MU Researcher Finds

COLUMBIA, MO -- According to a new study from the University of Missouri-Columbia, the risk of death from an inflicted injury increases nearly 50-fold for young children living in households with adults unrelated to them compared to children living with two biological parents.

In a study published in the November issue of Pediatrics, Patricia Schnitzer, assistant professor of nursing at MU, and Bernard Ewigman, professor of Family Medicine at the University of Chicago, used information from Missouri's Child Fatality Review Program, a system mandated by the state to ensure that all child deaths are properly reviewed, to identify all children 4-years-old and younger who died of an injury inflicted by a parent or other adult care giver over an 8-year period. Examples of inflicted injuries include shaking or striking the child, which accounted for 73 percent of the deaths in the study, as well as suffocation, burns, and drowning.

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Missouri's Child Fatality Review Program reviews and collects information about every child death that occurs in the state, including information about who lives in the child's house and their relationship to the child. Information collected on injury deaths includes details about the injury event, including information about who inflicted the injury if applicable.

Additional results show that children from single-parent households are not at increased risk for inflicted injury death as long as no other adults live in the home. Schnitzer said this clarifies the common misconception that children in single-parent households are more likely to experience child abuse and neglect.

"Because of the detailed information collected by the Child Fatality Review Program, we were able to classify households based on the relationship of each adult to the deceased child," Schnitzer said. "Consequently, we were able to distinguish between households with only single parents and those with a single parent and one or more adults, related or unrelated to the child. Other studies and national statistics have not reported nor recorded this level of detail on households with children."

The study also summarizes information about the perpetrators and reports that most perpetrators were male. Only 35 percent were the child's biological father. Most perpetrators lived with the child when the injury was inflicted. Eighty percent of households with an unrelated adult resident consisted of the single mother and her boyfriend. The boyfriend was the perpetrator in 74 percent of these households. Schnitzer said that parents of young children face tremendous stress and these stressors are often compounded for single parents.

"It's not uncommon for single mothers to be working or attending to other needs of the household when the child is injured," Schnitzer said. "Often, she has left the child in the care of her boyfriend or the child's father who then inflicts injury."

Educational programs offered to both male and female caregivers, as well as other resources such as home visits by nurses and subsidized childcare could benefit high risk families and help reduce the chance of inflicted injury. Recently, the National Women's Law Center found that Missouri ranks last in subsidizing child care to low-income families, Schnitzer said.



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