Georgia Child Fatality Review Panel annual report calendar year 2001

GEORGIA CHILD FATALITY REVIEW PANEL
Annual Report Calendar Year 2001
Office of Child Fatality Review 506 Roswell Street, Suite 230
Marietta, Georgia 30060 Phone: (770) 528-3988 Fax: (770) 528-3989
Website: www.gacfr.org

GEORGIA CHILD FATALITY REVIEW PANEL
MISSION
To serve Georgia's children by promoting more accurate identification and reporting of child fatalities, evaluating the prevalence and circumstances of both child abuse cases and child fatality investigations, and monitoring the implementation and impact of the statewide child abuse prevention plan in order to prevent and reduce incidents of child abuse and fatalities in the State.
Acknowledgements The Georgia Child Fatality Review Panel wishes to acknowledge those whose enormous commitment,
dedication, and unwavering support to child fatality review have made this report possible. These include:
Dr. John T. Carter, Ph.D., Jill Andrews, Mathew Sacrinty, and associates of the Epidemiology Department of Emory University, Rollins School of Public Health
All the members of county child abuse protocol and child fatality review committees All the public/private agencies that have so willingly collaborated with this office and provided
support 2

GEORGIA CHILD FATALITY REVIEW PANEL

MEMBERS

Chairperson Duncan D. Wheale Superior Court Judge, Augusta Judicial Circuit

Ms. DeAlvah Simms Child Advocate for the Protection of Children3

Dr. Todd Jarrell, M.D. Board Chair, Dept. of Human Resources3

Sharon Hill, Associate Judge Fulton County Juvenile Court

Mr. Vernon Keenan, Acting Director Georgia Bureau of Investigation3

Ms. Carol O. Ball, SAFE KIDS of GA.

Representative Georganna T. Sinkfield Member, GA House of Representatives2

Kathleen Toomey, M.D. Director, Division of Public Health3

Ms. Juanita Blount-Clark, Director Division of Family & Children Services3

Ms. Vanita Hullander Coroner, Catoosa County

Dr. Kris Sperry Chief Medical Examiner3, GBI

Ms. L. Gale Buckner Executive Director
Criminal Justice Coordinating Council3

Randall Alexander, M.D. Morehouse College
Center for Child Abuse

Detective Charles Spann Cobb County Department of Public Safety

Senator Nadine Thomas Member, GA Senate1

Mr. J. Tom Morgan District Attorney, Stone Mountain Judicial Circuit

STAFF

Eva Y. Pattillo Executive Director

Kim Washington

Karen Robinson

Program Manager

Research Data Contractor

________________________________________

Suhda Nuguru Administrative Assistant

The Georgia Child Fatality Review Panel is an appointed body of 16 representatives that oversees the county child fatality review process, reports to the governor annually on the incidence of child deaths, and recommends prevention measures based on the data. Two year appointments are made by the governor except as otherwise noted.

1 Appointed by the Lieutenant Governor

2 Appointed by the Speaker of the House of Representatives

3 Ex-Officio

3

MESSAGE FROM THE CHAIR
4

TABLE OF CONTENTS
Mission..............................................................................................................................................................2 Members ..........................................................................................................................................................3 Message from the Chair ....................................................................................................................................4 List of Figures....................................................................................................................................................6 Executive Summary ..........................................................................................................................................7 Recommendations ............................................................................................................................................9 Child Deaths in Georgia ..................................................................................................................................10
Summary of All Child Deaths ..........................................................................................................10 All 2001 Reviewed Deaths ................................................................................................................13 Child Abuse and Neglect ..................................................................................................................14 Prior Agency Involvement ................................................................................................................16 Sudden Infant Death Syndrome........................................................................................................17 Unintentional Injury-Related Deaths ................................................................................................19
Motor Vehicle-Related ......................................................................................................................19 Drowning..........................................................................................................................................21 Fire-Related ......................................................................................................................................22 Intentional Injury Deaths..................................................................................................................24 Homicides ........................................................................................................................................24 Suicides ............................................................................................................................................26 Firearm Deaths ................................................................................................................................27 Race, Ethnicity and Disproportionate Deaths ..................................................................................................29 History of Child Fatality Review in Georgia ....................................................................................................30 Appendices......................................................................................................................................................31
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LIST OF FIGURES AND TABLES

Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 10. Figure 11. Figure 12. Figure 13. Figure 14. Figure 15. Figure 16. Figure 17. Figure 18. Figure 19. Figure 20. Figure 21. Figure 22. Figure 23. Figure 24. Figure 25. Figure 26. Figure 27. Figure 28. Figure 29. Figure 30. Figure 31. Figure 32. Figure 33. Figure 34. Figure 35. Figure 36. Figure 37. Figure 38. Figure 39. Figure 40. Figure 41. Figure 42.

Deaths to Children Under 18 in Georgia, All Causes All Child Deaths by Race and Gender All Causes of Death, Age <1 All Causes of Death, Age 1-4 All Causes of Death, Age 5-14 All Causes of Death, Age 15-17 Number of Reviewed Child Deaths by Cause of Death Circumstances of Death for Reviewed Deaths with Abuse/Neglect Findings Relationship of Perpetrators to Decedent in Reviewed Cases with Abuse and Neglect Findings Age Distribution for Reviewed Deaths with Abuse or Neglect Findings Reviewed Deaths with Abuse or Neglect Findings by Race and Gender Agency Involvement: Reviewed Deaths with No Child Abuse/Neglect Findings Agency Involvement: Reviewed Deaths With Child Abuse/Neglect Findings Reviewed SIDS Deaths by Age Reviewed SIDS Deaths by Race and Gender Sleeping Positions At the Time of Death for Infants Who Died of SIDS SIDS Death Rates per 1,000: Age <1, 1994-2001 Reviewed Unintentional Injury-Related Deaths by Cause Reviewed Motor Vehicle-Related Deaths by Age Reviewed Motor Vehicle-Related Deaths by Race and Gender Motor Vehicle Fatality Rates per 100,000: Ages 15-17, 1994-2001 Reviewed Deaths Due to Drowning by Age Reviewed Drowning Deaths by Race and Gender Place of Drowning Drowning Fatality Rates per 100,000: Ages <18, 1994-2001 Reviewed Deaths Due to Fire by Age Reviewed Deaths Due to Fire by Race and Gender Fire-Related Fatality Rates per 100,000: Ages <18, 1994-2001 Reviewed Homicides by Circumstances of Death Reviewed Homicide Deaths by Age Reviewed Homicide Deaths by Race and Gender Death Rates for Teen Homicides per 100,000: Ages 15-17, 1994-2001 Reviewed Suicide Deaths by Age Reviewed Suicide Deaths by Race and Gender Suicide Death Rates per 100,000: Ages 15-17, 1994-2001 Reviewed Firearm Deaths by Manner of Death Reviewed Firearm Deaths by Age Reviewed Firearm Deaths by Race and Gender Reviewed Firearm Deaths by Type of Firearm Firearm Death Rates per 100,000: Ages 15-17, 1994-2001 Deaths to Children <1 and Percent of Population in Georgia, by Race and Gender Deaths to Children 1-17 and Percent of Population in Georgia, by Race and Gender

APPENDICES Appendix A Criteria for Child Death Reviews Appendix B Child Fatality Review Timeframes and Responsibilities Appendix C.1 2001 Total Child Fatalities by Age, Race, Gender, and Cause of Death Appendix C.2 2001 Reviewed Deaths by Age, Race, Gender, and Cause of Death Appendix C.3 2001 Reviewed Deaths with Abuse Findings by Age, Race, Gender, and Cause of Death Appendix C.4 Prevention Potential by Cause of Death, by Abuse Classification Appendix D County Compliance with Reviewing Eligible Deaths (Map) Appendix E 2001 Child Fatality Reviews by County, by Age Group Appendix F Definitions of Terms and Abbreviations Used in this Report
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Prevention - A popular term used today that we're all familiar with, and whose essence we subscribe to in many areas of our lives...or do we really? Prevention necessitates purposeful thought and plan if it is to be successful. Prevention often means foregoing the "norm" and our "business as usual" attitude, and requires us to construct a new paradigm to direct our actions.
The term "prevention" is frequently used in discussions regarding safety and protection of children. Study after study has shown that employing prevention measures to safeguard children are much less costly in the long run. Not only are they less costly economically, but also emotionally and socially for families, communities, and the state. Prevention also produces a more desirable outcome - healthy children growing up to become productive adults. Too often our budgets, policies, and procedures, belie our declaration regarding prevention. A look at the number of child deaths both nationally and in Georgia reveals a need for all of us - government, communities, individuals - to develop a sound, well thoughtout, prevention plan.
During this past legislative session, the Governor and Georgia General Assembly again increased funding for child protection. Increased funding is essential to adequately serve and protect children who have been abused. However, to protect children from the risk of all injuries, including abuse, our resolve must be to invest the resources necessary on the front end (prevention) that will afford our children an opportunity to survive and become healthy adults.
In 2001, 1,799 children died in Georgia according to Vital Records. The Georgia Child Fatality Review Panel publishes an annual report which contains detailed information regarding deaths which were sudden, unexpected, and/or unexplained. This information is compiled from reports submitted by local county child fatality review committees. The Georgia Child Fatality Review Panel is charged with not only tracking the numbers and causes of child deaths, but also identifying and recommending prevention strategies that could reduce the number of child deaths.

Key Findings

EXECUTIVE SUMMARY

Fatal Child Abuse/Neglect
Child fatality review committees determined that 94 child deaths resulted from suspected or confirmed abuse and/or neglect. Thirty-seven (37) of those abuse related deaths were ruled homicides. Children under the age of 5 accounted for (78%) of homicides resulting from abuse. Perpetrators were identified in 47 of the child abuse related deaths and 63% of those perpetrators were parents.

Natural
Death certificate data indicated a total of 1,322 children under the age of 18 died of natural causes (including SIDS). Infants accounted for the vast majority (1,079) of those deaths. The leading causes of infant deaths continued to be congenital anomalies, low birth weight, and prematurity. There were 116 SIDS deaths.
Child fatality review committees reviewed 186 deaths from natural causes. One hundred-three (103) of those deaths were SIDS. Committees are required to review all SIDS deaths, and medical deaths that are unexpected or unattended by a physician.

Unintentional Injuries Death certificate data indicated that 63% of deaths (415) in children ages 1 17 resulted from injuries. Seventy-six percent (76%) of all injuries in this age group resulting in death were unintentional. The 3 leading causes of unintentional injury related deaths in all age groups included:
224 motor vehicle incidents 40 Drowning Incidents 31 Suffocations
The most marked increase in deaths from 2000 was deaths from poisoning (43%), and the most marked decrease was suffocation (21%).
Child fatality review committees reviewed 264 deaths determined to have resulted from unintentional injuries.

7

Intentional Injuries Death certificate data indicated 105 children died from injuries intentionally inflicted by themselves or by others (suicide and homicide). In 2001, there were 71 homicides ( a 7% decrease from 2000), and 34 suicides (a 13% increase).
Child fatality review committees reviewed 87 deaths from intentional causes 54 homicides and 33 suicides.
Firearm Deaths Death certificate data indicated firearms were used in 47 child deaths. Twenty-seven (27) of those deaths were ruled homicides, fifteen (15) suicides, and five (5) unintentional shootings.
Child fatality review committees reviewed 37 firearm related deaths. Eighty-seven percent (87%) were intentional. The type of firearm was identified in 35 of the 37 reviewed firearm related deaths. Handguns were most frequently used (21 of the 37 reviewed firearm deaths).

Preventability
A primary function of the child fatality review process is to identify those deaths believed to be preventable. The issue of preventability was addressed in 530 of the 537 child deaths reviewed. Child fatality review committees determined that 410 (77%) of the 530 child deaths were definitely or possibly preventable.
Agency Involvement/Intervention
Child fatality review committees reported that in 82% (77) child abuse/neglect related deaths, the child and/or family had prior involvement with at least one state or local agency. Committees identified 6 instances in which agency intervention could have prevented child abuse/neglect related deaths.

8

ACCOMPLISHMENTS, RECOMMENDATIONS, AND GOALS OF THE
GEORGIA CHILD FATALITY REVIEW PANEL

Accomplishments:

Agency Recommendations:

1. Secured funding for on-line reporting system to assist counties with filing child fatality reports
2. Successfully engaged in collaborative efforts with other agencies, including: - Access to the GBI autopsy database - Agreement with GBI to assist with further development of child death investigation teams across the state
3. More timely response in provision of training and consultation of county child fatality review committees
4. Eight percent (8%) increase in county reporting compliance
5. Wider distribution of Panel's Annual Report (from 500 in year 2000 to 1000 copies in 2001)
Legislative Recommendations:
1. Fully implement recommendations of the Child Protective Service Task Force to improve the state's ability to protect children from child abuse and neglect
2. Fund expansion of home-based family support models that promote and enable appropriate parenting skills for prevention of child abuse and neglect
3. Require fences and gates in public and private swimming pools statewide
4. Require an autopsy, including toxicology studies, for every death of a child under the age of seven with the exception of children who are known to have died of a disease process while attended by a physician. Further, require complete skeletal x-rays (following established pediatric and radiological protocol), of the bodies of children who died before their second birthday
5. Pass a "Child Endangerment Law" to hold adults accountable who knowingly create or allow children to be placed in dangerous situations
6. Provide sufficient funding to the Georgia Child Fatality Review Panel to fulfill statutory requirements
7. Expand funding for mental health services for children, especially those identified as "at risk"

1. DFCS: The Panel recommends that all cases of newborns whose mothers have a positive drug screen be referred to Juvenile Court
2. DFCS: The Panel recommends that when a child dies due to a parent or caretaker's neglect or aggression, ongoing efforts be made to visit the surviving children in that home to assess their safety and well-being, and enable voluntary referrals to appropriate services
3. Coroner & Medical Examiner's Office: The Panel recommends that a death scene investigation be conducted for any child death suspected of being accidental, a homicide, or of unknown causes. No case should be classified as SIDS unless a death scene investigation and review of the clinical circumstances are completed
Goals:
1. Development of a "Best Practices" manual for county child abuse protocol committees
2. Publish and distribute "Child Fatality Review Policy and Procedures" manual
3. Facilitate a 10% increase in county reporting of child fatalities

9

CHILD DEATHS IN GEORGIA
Child death in Georgia has been the focus of many news articles, task forces, and legislative efforts. In 2001, 1,799 children died in Georgia, which was equivalent to almost five child deaths a day. Most of those deaths were due to medical causes (1,206),and occurred among infants (963). The remaining deaths (593) were the main focus of child fatality review committees. (Medical deaths are indicated for review only if unexpected or unattended by a physician.) The purpose of the child fatality review process is to analyze all circumstances of child deaths. This process is critical in identifying prevention strategies that can help reduce these needless deaths and improve the well-being of Georgia's future generations.
Information Sources
Child fatality review reports are the primary source of data for this report. Child fatality review reports are submitted on deaths that are identified by the county coroner, medical examiner, or child fatality review committee. In addition to the SIDS and unintentional/ intentional deaths, the committee may identify other deaths as appropriate for review. Child fatality review reports provide details of the cause and circumstance of death, supervision at time of death, prior history of abuse or neglect, perpetrator(s) in child abuse-related deaths, and prior agency involvement. Reports also contain information regarding whether a

death might have been prevented and what measures might be taken to lessen the likelihood of a similar death occurring in the future.
The 2001 Vital Records death certificate file was used to describe all child deaths. This file was also used to identify the subset of deaths that met the criteria for review. The child fatality review file was linked with the death certificate file. The death certificate provides demographic information and states the official cause of death. These two data sources do not always agree on the cause or manner of death. Child fatality review committees determined 4 child deaths to have resulted from a different cause than that reported on the death certificate.
Of the 1,799 child death certificates filed in 2001, 593 met the criteria requiring review. Child fatality review committees reviewed 443 (75%) of those eligible deaths, in addition to 11 deaths for which no death certificate was issued, and 83 deaths related to medical causes. A total of 537 deaths were reviewed and are included in Appendix C.2 of this report.
Except as noted, information and figures from child fatality review reports are designated by the term "Reviewed Deaths", and include a total of 454 child deaths (injury-related and SIDS). All information on "Trends" is based on death certificate data.

SUMMARY OF ALL DEATHS
Figure 1 shows the causes of all 1,799 child deaths in Georgia in 2001. Natural causes were responsible for 73% (1,322) of all deaths, with 82% (1079) of those deaths occurring before age one.

The term "medical" when used in this report as a cause of death for infants does not include SIDS.

Findings

Figure 1. Deaths to Children Under 18 in Georgia All Causes based on Death Certificate

The total number of infant/child deaths (1,799) is higher than the totals for each of the preceding 3 years (an average of 1,734 for 1997 through 2000). In 2001, the largest increase in deaths was associated with motor vehicles (from 195 in 2000 to 224)
Changes in the number of deaths in other cause categories are consistent with annual fluctuations

Medical (not to scale) Motor Vehicle SIDS Homicide Drowning Suicide Suffocation
Other Accident Fire / Burns

116 71 40 34 31 24 23

1206 224

Unknown 20

10

Poisoning 10

0 50 100 150 200 250 Deaths

Figure 2. Race and Gender of All Child Deaths

Other Male,
AA 23 Female,
339

Other Female, 18
White Male, 571

AA Male, 490

White Female,
358

Findings African American children make up 34% of the child
population; however, their deaths make up 46% of all child deaths Although not shown in the figure, there was an increase in deaths among Hispanic children (85 in 2000 to 95 in 2001) Ninety-one (91) of the 95 Hispanic deaths report race as "White"

Figure 3. All Causes of Death, Age < 1

Medical (not to scale) SIDS
Suffocation Unknown
Other Accident Homicide
Motor Vehicle

18 15 13 10 6

963 116

0

50

100

150

Deaths

Findings Only 62 (5%) infant deaths resulted from unintentional or intentional injuries. This was a slight decrease from
last year (65), but higher than the 48 in 1999 Of defined causes, suffocation (18) represented the largest single injury-related category Of the 95 Hispanic deaths discussed in Figure 2 Findings, 76% (73) were due to natural
causes, with 78% (57) of those being infant deaths

11

Figure 4. All Causes of Death, Age 1-4

Medical Causes

Motor Vehicle

34

Homicide

28

Drowning

16

Fire / Burns

13

Other Unintentional

11

Suffocation 6

Unknown 3

0

20

40

60

Deaths

92
Findings Deaths among this age group
increased in 2001 (from 174 in 2000 to 203) The largest increase was in homicide deaths - from 16 in 2000 to 28 in 2001 Deaths due to fire, MV, and drowning also increased
80 100

Figure 5. All Causes of Death, Age 5-14 Medical Causes Motor Vehicle Drowning Homicide Suicide Suffocation
Other Unintentional Fire / Burns

14 13 7 7 6 6

106 77

0 20 40 60 80 100 120

Findings

Deaths

55% of deaths in this age group were caused by injuries

59% of those injuries were motor vehicle related, representing an increase from 2000 (47%)

Figure 6. All Causes of Death, Age 15-17

Motor Vehicle

107

Findings

Medical Causes

45

There was little change in the

Suicide

27

number of deaths to older teens - from 225 in 2000 to 219 in

Homicide

20

2001 80% of all deaths were due to
unintentional and

Drowning 8 Poisoning 5

intentional injuries Over 60% of injury related

Other Unintentional 5

deaths were due to motor vehi-

Unknown 2

cle crashes 12

0 20 40 60 80 100 120

Deaths

In 2001, 593 of the total 1,799 child deaths met the criteria requiring review (injuries and SIDS) according to death certificate data. Committees filed reports for 75% (443) of those deaths within the reporting period, representing an increase of 8% since calendar year 2000. (This increase is attributed to the availability of more resources to local child fatality review committees for training and technical assistance.) Committees reviewed an additional 94 child deaths for a total of 537 deaths reviewed.
The distribution of child deaths in Georgia is generally proportional to the county population. The 14 counties with 10 or more reviewable deaths
in 2001 have 50% of the child population and 44% of all reviewable deaths. Those counties

ALL 2001 REVIEWED DEATHS
reviewed 85% (222) of their 262 reviewable deaths. Only one of the 14 counties reviewed less than 50% of the reviewable deaths One hundred thirteen (113) counties with from 1 to 9 reviewable deaths had a total of 331 reviewable deaths and reviewed 67% (221) of the deaths. Thirty-four of the 113 counties did not review any of their reviewable deaths Nine counties had no child fatalities in 2001, and an additional 23 counties had no child fatalities that met the review criteria
Four hundred fifty-four deaths, (injuries and SIDS), are discussed in the "Reviewed Deaths" sections of this report. Reviews of medical deaths are not included unless noted.

Figure7. Number of Reviewed Child Deaths by Cause (includes medical)

Motor Vehicle

151

SIDS

103

Medical Causes

83

Homicide

54

Suicide

33

Suffocation

29

Other Unintentional

29

Drowning

28

Fire / Burns

21

Unknown 6

0

50

100

150

200

Finding

Reviewed Deaths

Injuries due to motor vehicle incidents continued as a leading cause of death among children

Preventability

Each child fatality review report asks the team to determine whether the death could have been

The CFR committees' determination of preventability depends on the cause of death (see Appendix C.4).

prevented. Only 7 of the 537 reviews submitted in

Less than 5% of the reviewed "Natural" deaths were

2001 omitted this information. Of the remaining 530

judged "Definitely Preventable". However, more

reports addressing preventability, teams reported the

than 50% of homicide and unintentional deaths were

following:

determined to be "Definitely Preventable". Fifty (50)

of the 58 deaths (86%) with confirmed child abuse

Definitely Preventable 39%

Possibly Preventable 38%

Not Preventable

23%

were considered to be preventable, while 32% of deaths with no findings of abuse were determined to be definitely preventable.
13

In 2001, there were 63,488 cases of child abuse/ neglect investigated in Georgia. Thirty-five percent (35%) of those cases were confirmed. Ninety-four (94) reviewed child deaths were determined by Child Fatality Review Committees to have been suspected (36) or confirmed (58) child abuse and/or neglect. (Data on the cause of death,

CHILD ABUSE AND NEGLECT
age, race and gender for those deaths are included in Appendix C.3 of this report.) A history of domestic violence in the home of the decedent was also associated with a committee finding of child abuse. Sixteen percent (16%) of deaths with an abuse finding had a history of domestic violence compared to only 5% of deaths with no abuse findings.

Figure 8. Circumstances of Reviewed Deaths with Abuse/Neglect Findings

findingHs owmeirceidheomicides

Drowning

10

Motor Vehicle

9

Suffocation

7

SIDS

7

Fire/Burns

7

Other Unintentional

4

Poison

4

Unknown

3

Suicide

3

Medical

3

0

10

20

30

Reviewed Deaths

Perpetrators

37
Findings 39% of reviewed deaths with child abuse
or neglect findings were homicides Of the 37 homicides, 3 were confirmed
to be the result of Shaken Baby/Sudden Impact Syndrome, and an additional one as the result of being crushed
40

Figure 9. Relationship of Perpetrator to Decedent in Reviewed Cases with Abuse and Neglect

Parent Paramour of Parent
Other Non-relative Friend/Acquaintance
Child Care Worker Grandmother Missing

8 5 4 1 1

32 47

0

10 20 30 40 50

Reviewed Deaths

Findings Local Child Fatality Review Committees
identified a total of 51 perpetrators in 47 of the deaths (50%) Among the identified 51 perpetrators, 63% (32) were the child's natural parent

* Total = 51, reflecting 4 cases with 2 perpetrators identified

14

Figure 10. Age Distribution for Reviewed Deaths with Abuse or Neglect Findings

Reviewed Deaths

50

40

30

26

20

10

0

<1

47

14

1-4

5 - 14

Age Range (years)

7 15 - 17

Findings 78% were under the age of 5 28% were under the age of 1 In 2000, there were more cases
of infant abuse (42) than of abuse to 1-4 year olds (25) compared to 2001

Figure 11. Reviewed Deaths with Abuse or Neglect Findings by Race and Gender

AA Female, 20
AA Male, 32

White Male, 25
Other Female, 4 White Female, 13

Findings 55% (52) of deaths were to African American
children
61% (57) of deaths were to males and 34% (32) were to African American males

Opportunities for Prevention Promote prevention of child maltreatment as a community endeavor, adhering to proven prevention practices
within all sectors of the community Expand home-based family support and visitation programs to prevent abuse and neglect Adopt a Child Endangerment law that penalizes adults who knowingly place children in
dangerous situations and circumstances Authorize DFACS to access law enforcement and court records regarding domestic
violence in order to better assess the safety of children referred to their care Encourage Child Abuse Protocol Committees and Child Fatality Review Committees to take a proactive role in
informing communities about prevention needs and successful prevention strategies For more information on Child Abuse Prevention please contact Prevent Child Abuse
Georgia (800) 532-3208 or www.preventchildabuse.org
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Sixty three percent (336) of all 537 child fatality review reports received for 2001 indicated that one or more community agencies had prior interaction with the deceased child or his/her family. Agencies were not necessarily actively involved with children or families at the time of the deaths. The

PRIOR AGENCY INVOLVEMENT
following figures list the agencies and the number of deaths in which they were identified. A child or family was often involved with more than one agency; therefore, the number of agency involvements exceed the number of deaths.

Figure 12. Agency Involvement: Reviewed Deaths with No Child Abuse/Neglect Findings

No Agency Indicated Health Department DFCS/CPS Law Enforcement Court
DFCS/Public Assistance DJJ
Other Agency

55 54 47 38 38

184 148 111

Findings 58% of deaths (259) with no abuse find-
ings had prior agency involvement Families had involvement with an average
of 1.9 agencies 36% of families had involvement with the
Department Family & Children Services 33% of families had involvement with
Public Health

0

50 100 150 200

Number of Deaths

Figure 13. Agency Involvement: Reviewed Deaths With Child Abuse/Neglect Findings

Findings 82% of deaths (77) with abuse findings had

Health Department

prior agency involvement

DFCS/CPS

Families had involvement with an average 2.2 agencies

Law Enforcement

60% of families had involvement with the

Court

Department of Family & Children Services

No Agency Indicated

49% of families had involvement with Public

Health

DFCS/Public Assistance

For the 44 children/families known to Child

Other Agency

Protective Services, 8 reports did not indicate the nature of the involvement. For the

DJJ

remaining 36 children/families, involvement

0

was as follows:

46 44 28 18 17 12 10 8
10 20 30 40 5 Number of Deaths

Decedent

9

Both decedent and another child in the family

11

Another child in the family, not the decedent

10

Decedent, another child in family, and caretaker

3

Caretaker

1

Other child and caretaker

1

Decedent and caretaker

1

16

SUDDEN INFANT DEATH SYNDROME
Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under one year of age that remains unexplained after completion of 1) an autopsy, 2) a thorough investigation of the death scene, and 3) a review of the clinical history. SIDS is the most common cause of death among normal birth-weight infants between one month and one year of age. It is estimated that at least 3,000 infants within the U.S. die as a result of SIDS each year.
SIDS continued to be a leading cause of infant death in Georgia. In 2001, death certificates listed 116 infant deaths as SIDS. Child fatality review committees reviewed 103 deaths that were determined to be SIDS.
Prior to 1999, SIDS was a "definition by exclusion", meaning all known causes were to be ruled out before selecting SIDS as a cause of death. However, since the introduction of a new coding system (ICD10) for classifying diseases, SIDS is no longer defined by exclusion of all other causes. Georgia death certificates included 112 deaths with SIDS as

the underlying cause and an additional 6 deaths with SIDS as a secondary cause. For the child fatality review analysis, 4 of the 6 deaths with SIDS as a secondary cause were included in the total SIDS deaths based on additional information obtained in the child fatality review process.
Child fatality review committees reviewed several infant deaths that related to "co-sleeping". Cosleeping is a term used to describe an infant sleeping in the same bed with one or more individuals. The coding of SIDS on death certificates appears to acknowledge that co-sleeping (and suffocation of the infant) is a possible cause of death. Twenty Georgia death certificates in 2001 had a combination of SIDS and "suffocation, unknown intent" for the underlying secondary causes of death.
The good news is that the SIDS death rate in Georgia has declined by over 40% since 1990, according to the Office of Infant and Child Health Services of the Division of Public Health.

Figure 14. Reviewed SIDS Death by Age

Number of Deaths

40

30

30

20

20

15

12 12

10 2 0

412211

0 1 2 3 4 5 6 7 8 9 10 11

Age (months)

* 1 death missing DOB and DOD

FIGURE 15. Reviewed SIDS Death by Race and Gender

Other Male, 3 AA Female, 23

Other Female, 2
White Male, 33

AA Male, 24

White Female,
18

Finding 65% (67) of SIDS deaths
occurred among infants 0 to 3 months of age
Findings 46% (47) of SIDS victims were
African American 58% (60) of SIDS victims were
male
17

FIGURE 16. Sleeping Position of Infants Who Died of SIDS

Unknown, 29

On Stomach, 37

On Side, 12

On Back, 25

Findings Committees responded to the question
regarding sleep position for 102 SIDS deaths. Sleep position was known in 73% (74) of those deaths
For known sleeping positions, 50% (37) of the victims were reported to be sleeping on their stomachs, and 34% (25) were reported to be sleeping on their backs

SIDS TRENDS
Figure 17. SIDS Deaths Rates Per 1,000, Age <1, 1994-2001

Death Rate (per 1,000 births)

3.159096

1997

1998

1999

2000

2001

31

35

36

28

31

23

40

236.00 27

27

22

17

21

20

35

28

27

26

31

47

27

329.50 16

22

25

26

22

24

131

109

115

102

108

113

112

2.00

1.159096

1997

1998

1999

2000

2001

1996

1997

1998

1999

2000

2001

0.814.00 0.94

0.93

0.70

0.74

0.54

0.92

01..77048 .50

0.76 1.44

0.73 1.33

0.58 1.25

0.43 1.45

0.51 2.09

0.48 1.22

21..01077 .00

0.84 0.96

1.13 0.97

1.22 0.83

1.25 0.85

1.00 0.85

1.11 0.84

1994 1995 1996 1997 1998 1999 2000 2001

White Males White Females AA Males AA Females

Findings There has been little apparent change in the rate of infant deaths due to SIDS over the past six years. The
striking decrease that occurred in the early `90s (and has been attributed to the "Back to Sleep" message) has not continued The annual number of infant deaths in Georgia attributed to SIDS has averaged 110 for the past six years. The current death rate (aproximately .85 per 1000 births) is less than half the rate during the early `90s Male infants are about 50% more likely to die due to SIDS than female infants, and African Americans are about twice as likely as white infants to die due to SIDS
Opportunities for Prevention
Educate the public (targeting African American communities) about risk reduction including back sleeping, breastfeeding, prenatal smoking cessation, smoke free environment and use of firm bedding materials
Incorporate risk reduction information in prenatal education for expectant parents
Promote a statewide public education program on the risks of overlay when bed-sharing
For more information on SIDS, contact Georgia DHR Office of Infant and Child Health at (404) 657-4143 or SIDS Alliance (National) 1-800-221-SIDS (7437)

18

UNINTENTIONAL INJURY RELATED DEATHS

According to death certificate data, injuries were responsible for 477 child deaths. Three hundred seventy-two (372) of those deaths were unintentional. Child fatality review committees reviewed 264

injury-related deaths determined to be unintentional. Figure 18 shows the distribution of those deaths by type of injury. Committees could not determine the manner of death in 6 instances.

Figure 18. Reviewed Unintentional Injury-Related Deaths by Cause

Motor Vehicle

151

Suff/Strang

29

Drowning

28

Fire

21

Other Unintentional 11

Poisoning 9

Unknown 6

Gun 5

Fall 4 accidents
under the a0ge of 5 50

100

150

200

Number of Deaths

Findings 57% (151) of deaths resulted from motor
vehicle-related incidents 36% (96) of injury-related deaths
occurred among children under the age of 5

MOTOR VEHICLERELATED DEATHS
Nationally, motor vehicle crashes remain the leading cause of unintentional injury-related deaths for children 1-14 years old. Twenty-five percent of those children killed between the ages of 5 and 9 were pedestrians. Two out of five deaths among U.S. teens are the result of motor vehicle crashes.
In Georgia, motor vehicle incidents continue to be the leading cause of death among teens 15-17 and the leading cause of unintentional injury-related deaths to children between ages 1-17. Death certificate data indicated that 224 child deaths resulted from motor vehicle incidents. Child fatality review committees reviewed 151 child deaths that were related to motor vehicle incidents.
Of the 151 reviewed motor vehicle-related deaths, 72 (48%) involved children who were passengers, and 34 (22%) were operators of cars, trucks, SUVs, or vans. Information on the presence of restraints was provided for 77 of the reviewed deaths. It was determined that restraints were not used in 30 (42%) incidents in which a vehicle was known to be equipped with a restraint (71). The remaining 30% of the 151 reviewed motor vehicle-related deaths involved bicycles (2), all terrain vehicles (4), motorcycles (3), tractor trailers (2), other farm

vehicles (1), 1 passenger in an aircraft, and 32 pedestrians. Of the 9 children on bicycles, ATV's, and motorcycles, 4 were not wearing safety helmets.

FIGURE 19. Reviewed Motor Vehicle-Related Deaths by Age

80

75

70

Number of Deaths

60

50

40 30

28

21

22

20

1a0mong te5ens ages 15-17

of death0s increased as follows:

<1

1-4

Age 15 12 deaths 5 - 9AAggee 111670 - 133421 ddeeaa1tt5hhss- 17

Age Range (years)

Findings 50% of reviewed motor vehicle-related deaths
occurred among teens ages 15-17 As teens achieved legal driving age, the number of
deaths increased as follows:

Age 15 12 deaths

Age 16 32 deaths

Age 17 31 deaths

19

Figure 20. Reviewed Motor Vehicle-Related Deaths by Race and Gender

AA Female, 15
AA Male, 37

Other Male, 3

White Male, 56

Findings 64% (96) of deaths were white children 64% (96) of deaths were male children

White Female, 40
Motor Vehicle Trends
Figure 21. Motor Vehicle Fatality Rates per 100,000: Age 15-17, 1994-2001

Death Rate (per 100,000)

197970.00 1998 60 60.0400

38 50.0303

19 10

40.01058

128 30.0908

1999 47 26 17
5 95

2000 48 21 20 10 99

2001

44

51

26

28

16

21

6

6

94

107

20.00

10.00

19970.00 1998

1999

2000

2001

333841...5181751994 1942294695...7631303996 1942397513...0271984198 1994229066...2803001600 2004231673...678903

White Male White Female AA Male AA Female

Findings

The fatality rate due to motor vehicle crashes among young teens (ages 15-17) has been fairly stable for the past five years. There are approximately 28 deaths per year per 100,000 teens in that age group.
The motor vehicle death rate is higher among white teens than among African American teens, and the rates among males are higher than among females

Opportunities for Prevention

Enforce the Teenage and Adult Driver Responsibility Act

Support statewide availability of driver education programs

Continue to promote bicycle helmet use including education about proper fit and wearing position and establish funding to support community programs that provide helmets to families with young children in need of financial assistance to purchase safety equipment

Promote educational programs to teach proper installation and use of car seats and proper use of vehicle restraints

Encourage communities to provide car seats to families with infants and young children who need financial assistance to purchase safety equipment

Encourage pedestrian safety campaigns

For more information on prevention of motor vehicle crashes and the proper use of child safety seats & seat

belts, please contact the National Highway Traffic Safety Administration, 1-888-DASH-2-DOT or the National

20

Center for Injury Prevention and Control (770) 488-1506 www.cdc.gov

Drowning
Drowning is the second leading cause of injuryrelated deaths for children 1 through 14 years of age in the United States. Most children drown in swimming pools at the child's own home. For the nation as a whole, drowning rates are three times higher in rural areas.
According to death certificate data in Georgia, 40 children died as a result of drowning which was a

15% decrease from 2000. Child fatality review committees reviewed 28 drowning deaths of children under the age of 18 years. Information on the use of floatation devices was provided in 28 reviews which indicated none of the children wore a floatation device. Information regarding supervision was addressed in 26 of the 28 reviewed deaths. Committees determined that in 62% of drowning deaths, supervision was inadequate.

Figure 22. Reviewed Deaths Due to Drowning by Age

14

Number of Deaths

12

10

8

6

4

2

the age02s of 1 and 4

<1

12
7 4

1-4

5 - 9 10 - 14

Finding

Age Range (years)

50% of drowning victims were children under the age of 5

3 15 - 17

Figure 23. Reviewed Drowning Deaths by Race and Gender

AA Female, 2

White Male, 10

Finding 4.6 times as many drowning
deaths occurred among males as females

males as females
AA Male, 13

White Female, 3

Figure 24. Place of Drowning

Pool, 10

Natural, 10

Findings 36% of drowning victims died in a natural body

of water

36% of drowning victims died in a swimming

pool

The total number of drowning deaths in pools

8 in 2001

Bathtub, 8

remained the same from 2000 to 2001 (10)

Drowning deaths in bathtubs increased from 2 in

2000 to 8 in 2001

21

Drowning Trends
Figure 25. Drowning Fatality Rates per 100,000: Age < 18, 1994-2001

Death Rate (per 100,000)

1996 67..1000001997 5.00 4.1070

1998 22
11

1999 15
19

2000 22
20

2001 20 10 16

12
9White Male 16White Female

3.3060

51

41

56

53

39AA Male

2.00

AA Female

1.00

1996 0.001997

1998

1999

2000

2001

1.62 0.34 5.82

1994

13139...95165199 1996

12059...93657674 1998

13159...94369329 2000

23140...00471876

1.82 1.29 5.18

1.79

2.62

0.28

1.11

1.63

0.80

Findings Over the past eight years, an average of 46 chil-
dren drowned each year in Georgia The number of drowning deaths fluctuates, but
there is not any apparent trend The rate of drowning deaths among African
American males is consistently the highest of all race/sex groups

Opportunities for Prevention Increase public education efforts that teach water safety and skills among school age children Promote regulations and enforcement to limit alcohol use by operators of recreational boats Encourage Department of Natural Resources to establish stronger rescue capabilities at state swimming facilities Enact and enforce statewide ordinances related to fences and gates in public and private swimming pools For more information on prevention of drowning please contact the National SAFEKIDS Campaign at 202-
662-0600 www.safekids.org or American Red Cross (202) 639-3520 www.redcross.org

Fire /Burn Related Deaths

Residential fires are the most common cause of fire related mortality in the United States. Approximately half of deaths resulting from residential fires occur in homes without smoke alarms. Death certificate data for Georgia indicated a total of 23 fire-related deaths that represent a decrease from 2000 (26). Child fatality review committees reviewed 21 fire/burn related deaths in 2001. Two of those deaths resulted from burns due to hot water scalds.

Number of Deaths

Figure 26. Reviewed Deaths Due to Fire by Age

15

12

10

5 1
the 0age of 10 <1

3

3

2

1-4

5 - 9 10 - 14

Age Range (years)

15 - 17

Finding
76% of victims of fire related deaths were under the age of 10

22

Figure 27. Reviewed Deaths Due to Fire by Race and Gender

AA Female, 6

White Male, 7

from 8 in 2000 to 1 in 2001
AA Male, 7

White Female, 1

Finding African American children accounted
for 24% more fire-related deaths than White children

Fire-Related Trends
Figure 28. Fire-Related Fatality Rates per 100,000 Ages < 18, 1994-2001

Death Rate (per 100,000)

19967.00 1997

1998

1999

2000

2001

6.0150

6

6

5

4

9

5.00

White Male

7

4.011750

5

14

4

4

1 2

5 7

10 8

White

Female

3.0540

15

25

12

21

28 AA Male

2.00

AA Female

1.00

19960.00 1997

1998

1999

2000

2001

20..45311994 10099..90560 1996 1009..991757 1998 0019..769869 2000 002..0680221

1.37 0.16

4.36

1.42

3.88

0.27

1.32

2.59

Findings There have been an average of 30 fire-
related deaths per year for the past eight years There were an average of 47 deaths per year for 19941996, and the number dropped to 20 per year for the past three years (1999-2001) African American children are twice as likely to die in fires as White children

Opportunities for Prevention Continue to expand school fire safety programs that teach critical messages like "stop, drop and roll" and those
that help families plan fire escape routes Continue to expand community programs to provide smoke detectors and batteries to families who cannot
afford them Promote public education about the importance of changing smoke detector batteries every six months For more information on the prevention of fire related deaths and burn prevention, please contact the United
States Fire Administration, www.usfa.gov or the Georgia Firefighters Burn Foundation, (404 320-6223), www.gfbf.org, or SAFE Kids Campaign (203) 662-0600
23

The total number of deaths resulting from homicide and suicide (105) for 2001 changed little from 2000 (106), based on death certificate data. In 2001, local Child Fatality Review Committees reviewed a
Homicide is the second leading cause of death for people ages 10-19 in the United States. Child Fatality Review Committees reported 54 homicide

INTENTIONAL INJURY DEATHS
total of 87 deaths (54 homicides and 33 suicides) determined to be the result of intentional injuries. Thirty seven (37) of the 94 reported abuse related deaths were homicides.
Homicide
deaths. The figure below presents reviewed homicide deaths by circumstance of death.

Figure 29 Reviewed Homicide Deaths by Circumstance of Death

Firearm Struck

18 11

Poison

6

Fire

5

Suffocation

4

Undetermined

4

Shaken

3

Cut/Stabbed

2

homicCidreusshed

1

from being struck or stabbed

0

5

10

15

20

Findings:

Number of Deaths

Firearms were the cause of 1/3 of all reviewed homicides

24% (13) of homicide deaths were due to injuries resulting from being struck or stabbed

11% (6) of homicide deaths were due to poisoning

Figure 30. Reviewed Homicide Deaths by Age

25

23

Number of Deaths

20

15

10

9

5

rheovmieiwcie0dde

homicide deaths

deaths

<1

1-4

4

5

5 - 9 10 - 14

Age Range (years)

13 15 - 17

Findings: Children under 5 years of age represented 59% of all reviewed homicide deaths Teenagers ages 15-17 years represented 24% of all reviewed homicides which was a decrease from 2000 (33%)

24

Figure 31. Reviewed Homicide Deaths by Race and Gender

Findings 63% of homicide victims were male 56% of homicide victims were African American
compared to 47% in 2000

Other Male, 1
AA Female, 11

Other Female, 3

AA Male, 19
Homicide Trends
Figure 32. Death Rates for Teen Homicides per 100,000, Ages 15-17, 1994-2001

White Male, 14
White Female, 6

Death Rate (per 100,000)

189096.00 1997 2 60.00 6 27 40.0022
40 20.0035

1998 10
17
34

1999 7
17
33

2000 5
16
27

2001 9
11
26

5White Male 14White Female
AA Male 21AA Female

0.00

1.98 1996 5.189694191997959.614991699189967.616991899199949.70202000002080.134 2001 4.58

Findin2gs12

2 09

2 07

5 12

3 03

1 00

1 98

The number of teen homicides (ages 15-17) has decreased continuously during the past 8 years. The average

number of deaths per year over a three-year period has dropped from 42 (1994-1996) to 25 (1999-2001), and

the rate has decreased from 16 per 100,000 to 6 per 100,000

Over 60% of all Georgia teen homicide victims were African American males, and their homicide rate over the

past three years has been >20 deaths per 100,000

Opportunities for Prevention
Promote school and after-school programs teaching conflict resolution, impulse control, anger management and empathy
Support legislation and public service announcements promoting responsible gun ownership including use of firearm safety locks, safe firearm storage, and warnings to parents and other adults of the dangers to children, and liabilities to parents, of keeping loaded firearms in homes occupied or visited by children
Support legislation requiring American made guns to be subject to federal safety standards as are other consumer products

25

In 2001, local Child Fatality Review Committees reviewed 33 deaths of children who took their own lives. Death certificate data indicated a total of 34 suicide deaths which was an increase from 2000 (30). Firearms were used in 42% (14) of reviewed
Findings 76% (25) of reviewed suicide deaths occurred
to teens 15-17
The youngest reviewed suicide victim (11 years old) died of injuries sustained from strangulation due to hanging

Suicide
suicides. Strangulation (hanging) was the circumstance of death for another 16 reviewed deaths. Two deaths resulted from falls, and one death resulted from poisoning.

Figure 33. Reviewed Suicide Deaths by Age

30 25
25

Number of Deaths

20

15-17 y1e5ars old died o1f0injuries sustain8ed from stangulation due to hanging

5

0 10 - 14

15 - 17

Age Range (years)

Figure 34. Reviewed Suicide Deaths by Race and Gender

AA Female, 2
AA Male, 1
White Female, 5

Other Male, 2

Suicide Trends

White Male, 23

Findings 85% of all reviewed suicide victims were White
children 79% of all reviewed suicide victims were males 70% of all reviewed suicide victims were White
males

Figure 35. Suicide Death Rates per 100,000, Ages 15-17, 1994-2001

Death Rate (per 100,000)

Findings The average annual number of teen suicides (22) has
been lower the past 4 years (1998-2001) than the prior 4 years (31) Suicide rates for all 15-17 year olds declined each year from 1994 (11.3) through 1999 (4.94). Rates increased in 2000 (6.84) and again in 2001 (7.55) White males comprise over 60% of the suicide victims over the eight-year period, and their suicide death rate has averaged about 13 per 100,000 over the past four years
Opportunities for Prevention

21599.060 1997

1998

1999

2000

2001

20 20.00 18

15

13

10

12

15.00

10.00 1

1

1

32 5.00 28

28

21

17

24

0.00

19.82

1996171.95994

11999975141.94976

11999987121.39798191999999.2309002020000111.13

2001 18

4.24

3.14

5.17

5.12

5.06

6.00

3

W20hite Male

White Female

AA1 Male A2A7 Female

Increase the access and availability of mental health and substance abuse prevention and treatment services to children and youth

Increase awareness among parents, caretakers and communities of suicide warning signs, and promote prompt action when warning signs are recognized

26

Develop community intervention resources for children at risk of suicide

Advocate for safe home storage of firearms

FIREARM DEATHS
Firearm deaths include homicides, suicides, and unintentional injuries. It is estimated that every two hours in the U.S., a child is killed with a loaded gun. Most young homicide victims are killed with firearms. Ninety percent (90%) of unintentional shootings involving children are linked to easy-to-find, loaded handguns in the home. In Georgia, death certificate data indicated a total of 47 deaths caused by firearms. Child Fatality Review Committees reviewed 37 deaths caused by firearms. Child fatality review reports ask for information not available on death certificates, including source of the firearm, type of firearm, who was using the firearm at the time of death, and the age of the firearm handler. This information provides important guidance for prevention.

Figure 36. Reviewed Firearm

Deaths by Manner of Death

Count FA Source

on

Uni5ntePnatiorenanlt,

e

4 P5arent

e

1 Acquaintance

e

13 Unknown

7 Parent

1 Acquaintance

Suicide6, 1U4nknown

Homicide, 18

Finding 49% of firearm-related deaths were homicides

Figure 37. Reviewed Firearm Related Deaths by Age

Number of Deaths

Age 15-17 Circ

Count

2515 - 17 Hom

11

23

201155

-

17 17

Suic Unintent

10 2

15

10

9

ag5ed 15-17 2

3

olds, 48%0 (11) were homicides and 43% (10) were suicides

1-4

5-9

10 - 14

15 - 17

Age Range (years)

Findings 62% of reviewed firearm deaths
occurred to children aged 15- 17 Of reviewed firearm deaths among
15-17 years olds, 48% (11) were homicides and 43% (10) were suicides

Figure 38. Reviewed Firearm Deaths by Race and Gender
AA Female, 2

AA Male, 9
White hildren Female, 2

White Male, 24

Findings 70% of reviewed firearm deaths occurred
to White children 89% of reviewed firearm deaths
were males

Source of Firearm

In 49% (18) of reviewed firearm deaths, the firearm was obtained from someone the child knew (a parent, other relative or acquaintance)
Parents were the source of the firearm in 50% (7 of the 14) of reviewed suicides by firearm
The source of the firearm was unknown in 51% (19) of reviewed firearm related deaths 27

Type of Firearm

Figure 39. Reviewed Firearm Deaths by Type of Firearm

Number of Deaths

HaSnudicg2uF5nA

Type
21

Count

6

RShifoletg2un0

3 4

Other15

1

Hom FA Type Handgun Rifle Shotgun Unknown

Count 14 1 2 1

10

7

7

5

1

1

0

comparedHtaon6d6%guinn 2000Rifle Shotgun Other Unknown

were

to 5% (2) in 2000 committed with a firearm.

TOyf tpheesoe,f6Fdireeaathrsm(43%)

involved

a

Findings 57% (21) of the firearms were handguns com-
pared to 66% in 2000 19% (7) of the firearms were shotguns compared
to 5% (2) in 2000 14 of the 33 reviewed suicide deaths were com-
mitted with a firearm: 6 (43%) = handgun 4 = shotgun 3 = rifle 1 = other type
Of the 54 reviewed homicides, 33% (18) were committed with a firearm: 14 (78%) = handgun 2 = shotgun 1 = rifle 1 = firearm type unknown

Usage In 76% of firearm deaths (28) the shooter was aiming at himself or at someone else Three deaths were the result of the shooter "playing" with the firearm

Storage Storage of the firearm was only indicated in 7 of the 37 reviewed firearm deaths Of the 7 cases in which storage location was known, 6 indicated the firearm had not been secured to prevent
use by children or unauthorized adults

Age of Handler The shooter was under the age of 15 in 3 of 5 unintentional deaths The shooter was 15 or over in 66% (21) of all intentional deaths

Firearm Trends

Figure 40. Firearm Death Rates per 100,000, Ages 15-17, 1994-2001

Death Rate (per 100,000)

Findings All deaths attributed to firearms have declined
over the eight-year period. The average annual number of deaths was 67 for 1994-1996, and dropped to 31 for 1999 to 2001

1001.90906 1680.00
3260.00 40.00
5920.00

1997 28
26
66

1998 24
22
57

1999 17
18
47

2000 8
17
31

2001
12 White M15ale
13 White F13emale AA Male
32 AA Fem29ale

However, most of the decline in firearm

0.00

deaths has been in the African American male population. The firearm death rate in this population has declined from a high of 80 per 100,000 in 1994 to about 21 per 100,000 in

19961994 191995917996 199179918998 199919290900 20012000

2001

15.85 27.37 23.14 16.18

7.51 11.13 13.73

Opportunities for Prevention

2000 and 2001

Promote school and community-based risk reduction and

firearm safety programs for children, parents and other

caretakers

Promote the use of firearm safety devices, including trigger

locks

28

Support efforts to limit minors' access to firearms

RACE, ETHNICITY AND DISPROPORTIONATE DEATHS

Data are presented in this report by race and gender for each type of death to enable more detailed analysis. The terms "White", "AfricanAmerican" (A-A) and "Other" are used to identify racial groups throughout the report. "Other" refers to children of Asian, Pacific Islander, or Native

American origin. Death certificate data includes ethnicity information that can identify children of Hispanic origin. Ninety-one (91) of 95 deaths identified as Hispanic indicated the race as "White." The 4 remaining deaths identified as Hispanic indicated the race to be "Other".

Figure 41. Deaths to Children < 1 and Percent of Population in Georgia By Race and Gender

7.18 35 30

5.24

15.32

10.93

6.23

25

Percent

dea(1th312s.1505ocpecru1r,r0e0d0

among Black infants
births) was more than double

the

rate

for

White

infants

(6.23

per

1,000

10

5

0

White Males

White Females

AA Males

AA Females

Findings A disproportionate number of deaths
occurred among African-American infants

% Deaths % Population

All A-A Infants A-A-Male Infants

% of Deaths 50.3 29.6

% of Population 32.3 16.3

A-A Female Infants

20.7

15.9

The infant mortality rate for African-American infants (13.5 per 1,000 births) was more than double the rate for white infants (6.2 deaths per 1,000 births)

Figure 42. Deaths to Children 1-17 and Percent of Population in Georgia, By Race and Gender

50 adnedat1h7s34ao00rcecuarbroeudta5m0%ongmmoraelelikcehlyildtorednie than females in the same age range

Percent

20

10

0

White Males White Females

AA Males

AA Females

% Deaths % Population

Findings A disproportionate number of deaths

% of Deaths % of Population

occurred among male children

All Males 117

62.9

51.3

Males between the ages of 1 and 17 are

about 50% more likely to die than

AA-Males 117

23.1

17.5

females in the same age range

White Males 1-17

39.2

29.7

29

THE HISTORY OF CHILD FATALITY REVIEW IN GEORGIA

1990 - 1993
Legislation established the Statewide Child Fatality Review Panel with responsibility for compiling statistics on child fatalities and for making recommendations to the Governor and General Assembly based on the data. It established local county protocol committees and directed that they develop county-based written protocols for the investigation of alleged child abuse and neglect cases. Statutory amendments were adopted to: Establish a separate child fatality review team in
each county and determine procedures for conducting reviews and completing reports Change the name of the Statewide Child Fatality Review Panel to the Statewide Child Abuse Prevention Panel and require the Panel to: Submit an annual report documenting the prevalence and circumstances of all child fatalities with special emphasis on deaths associated with child abuse Recommend measures to reduce child fatalities to the Governor, the Lieutenant Governor, and the Speaker of the Georgia House of Representatives Establish a protocol for the review of policies, procedures and operations of the Division of Family and Children Services for child abuse cases Monitor implementation of the State Child Abuse Prevention Plan
1996 - 1998
The Statewide Child Abuse Prevention Panel established the Office of Child Fatality Review with a full-time director to administer the activities of the Panel
An evaluation of the child fatality review process was conducted by researchers from Emory University and Georgia State University. The

evaluation concluded that there were policy, procedure, and funding issues that limited the effectiveness of the review process. Recommendations for improvement were made to the General Assembly Statutory amendments were adopted to: - Identify agencies required to be represented on
child fatality review teams, and establish penalties for non-participation - Require that all child deaths be reported to the coroner/medical examiner in each county - Establish additional requirements for county child fatality review committees
1999 - 2002
Child death investigation teams were initially developed in four judicial circuits as a pilot project, with six additional teams later added. Team members were identified as law enforcement, coroner or medical examiner, district attorney representative, and department of family and children services representative. Teams assumed responsibility for conducting death scene investigations of child deaths within their judicial circuit that met established criteria
Statutory amendments were adopted which resulted in the Code section governing the Child Fatality Review Panel, child fatality review committees, and child abuse protocol committees being completely rewritten. The name of the Statewide Child Abuse Prevention Panel was changed to the Georgia Child Fatality Review Panel
The Panel's budget was increased to allow for 2 additional staff persons, and establishment of physical office space.
Funding was secured to purchase an on-line reporting system

30

APPENDIX A CRITERIA FOR CHILD DEATH REVIEWS
Child Fatality Review Teams are required to review the deaths of all children under the age of 18 that meet the criteria for a coroner/medical examiner's investigation.
"Eligible" Deaths or Deaths to be Reviewed by Child Fatality Review Teams O.C.G.A. 19-15-3(e)
The death of a child under the age of 18 must be reviewed when the death is suspicious, unusual, or unexpected. Included in this definition are incidents when a child dies:
1. as a result of violence 2. by suicide 3. by a casualty (i.e., car crash, fire) 4. suddenly when in apparent good health 5. when unattended by a physician 6. in any suspicious or unusual manner, especially if under 16 years of age 7. after birth but before seven years of age if the death is unexpected or
unexplained 8. while an inmate of a state hospital or a state, county, or city penal institution 9. as a result of a death penalty execution
31

APPENDIX B CHILD FATALITY REVIEW TIMEFRAMES AND RESPONSIBILITIES
32

APPENDIX C.1 Total Child Fatalities Based on Death Certificate

Infant (Age < 1)
Infant (Ages 1 to 4)

Cause of Death Drowning Fire / Burns Homicide Medical Causes Other Accident Poisoning SIDS Suffocation Unknown Vehicle Accident Total
Cause of Death Drowning Fire / Burns Homicide Medical Causes Other Accident Poisoning Suffocation Unknown Vehicle Accident Total

Infant (Ages 5 to 14)

Cause of Death Drowning Fire / Burns Homicide Medical Causes Other Accident Suffocation Suicide Vehicle Accident Total

White

Male Female

1

1

1

1

1

257 184

1

2

1

39

22

8

2

3

5

1

2

313 219

White

Male Female

6

6

5

8

4

37

17

6

1

1

1

1

14

11

78

40

White

Male Female

1

1

2

5

4

35

23

5

2

3

4

1

25

21

79

53

Black Male Female
1

5

3

292

197

2

1

2

28

26

5

2

3

4

1

2

338

236

Black

Male Female

4

2

6

6

10

22

14

1

1

3

2

1

1

6

3

44

38

Black

Male Female

11

1

3

1

3

1

14

34

1

2

1

20

11

54

49

Other Male Female

18

15

1 1

19

16

Other Male Female

1

1

1

1

2

Other Male Female

1 1

Total 2 2 10
963 6 3
116 18 15 6 1141
Total 16 13 28 92 9 2 6 3 34 203
Total 14 6 13 106 6 7 7 77 236

Infant (Ages

White

Black

Other

15 to 17)

Cause of Death

Male Female Male Female

Male Female Total

Drowning

4

1

2

1

8

Fire / Burns

2

2

Homicide

4

2

14

20

Medical Causes

13

10

14

8

45

Other Accident

3

3

Poisoning

5

5

Suicide

20

4

1

1

1

27

Unknown

1

1

2

Vehicle Accident

51

28

21

6

1

107

Total

101

46

54

16

2

219

33

APPENDIX C.2 Total Reviewed Child Fatalities 2001

White

Black

Other

Infant (Age < 1) Cause of Death

Male Female Male Female Male Female Total

Drowning

1

1

2

Fall

2

1

3

Fire / Burns

1

1

Homicide

1

4

3

1

9

Medical Causes

7

12

18

2

1

40

Other Accident

1

1

Poisoning

1

1

2

SIDS

33

18

24

23

3

2

103

Suffocation

5

1

6

1

1

2

16

Unknown

2

1

3

Vehicle Accident

1

2

1

1

5

Total

49

23

52

49

6

6

185

White

Black

Other

Ages 1 to 4

Cause of Death

Male Female Male Female Male Female Total

Drowning

6

2

4

12

Fall

1

1

Fire / Burns

5

2

5

12

Firearm

1

1

Homicide

7

3

5

7

1

23

Medical Causes

6

4

4

1

2

17

Other Accident

3

1

1

1

6

Poisoning

1

1

2

Suffocation

1

3

2

6

Unknown

1

1

2

Vehicle Accident

7

7

5

2

21

Total

39

17

23

18

4

2

103

White

Black

Other

Ages 5 to 14

Cause of Death

Male Female Male Female Male Female Total

Drowning

1

1

8

1

11

Fire / Burns

2

3

1

6

Firearm

2

2

Homicide

3

3

1

1

1

9

Medical Causes

7

3

4

7

21

Other Accident

2

1

3

Suffocation

1

3

3

7

Suicide

5

1

1

1

8

Vehicle Accident

16

12

13

8

1

50

Total

39

23

33

19

2

1

117

White

Black

Other

Ages 15 to 17 Cause of Death

Male Female Male Female Male Female Total

Drowning

2

1

3

Fire / Burns

2

2

Firearm

2

2

Homicide

3

9

1

13

Medical Causes

1

1

2

1

5

Other Accident

1

1

Poisoning

5

5

Suicide

18

4

1

1

1

25

34

Unknown

1

Vehicle Accident

32

19

18

6

1 75

Total

65

24

33

8

2

132

APPENDIX C.3 Reviewed Child Fatalities with Abuse Findings 2001

Infant (Age < 1)

Cause of Death Drowning Fire / Burns Homicide Medical Causes Poisoning SIDS Suffocation Unknown Total

Ages 1 to 4

Cause of Death Other Accident Drowning Fall Fire / Burns Homicide Vehicle Accident Poisoning Suffocation Unknown Total

Ages 5 to 14

Cause of Death Drowning Fire / Burns Homicide Vehicle Accident Suffocation Suicide Total

Ages 15 to 17

Cause of Death Homicide Medical Causes Vehicle Accident Suicide Total

White Male Female

1 1

1 2
1

3

3

White

Male Female

1

1

1

1

3

6

2

1

2

1

1

15

5

White

Male Female

2

3

1

1

1

1

4

5

White

Male Female

1 2 3

Black Male Female
1

4

2

1

1

1

4

1

2

1

13

5

Black

Male Female

1

4

1

1

5

7

2

1

1

1

1

13

12

Black

Male Female

3

1

1

3

2

Black

Male Female

3

1

3

1

Other Female
1
1 2 Other Female 1
1
2 Other Female
Other Female

Total 1 1 8 2 2 7 4 1 26
Total 3 6 1 5 21 5 2 2 2 47
Total 3 1 5 3 1 1 14
Total 3 1 1 2 7

35

APPENDIX C.4 Prevention Potential of Reviewed Child Fatalities by Abuse Classification and Cause of Death

Cause of Death
Medical SIDS Homicide Vehicle Crashes All Other Acc.
Total
Cause of Death
Medical SIDS Homicide Suicide Vehicle Crashes All Other Acc.
Total
Cause of Death
Medical SIDS Homicide Suicide Vehicle Crashes All Other Acc.
Total

Confirmed Abuse

Prevention Finding

Missing

Not Preventable

Possibly

1

3

2

1

1

4

4

Suspected (but not confirmed) Abuse

Prevention Finding

Missing

Not Preventable

Possibly

1 6 2 1 3 6

19

No Abuse Finding

Prevention Finding

Missing

Not Preventable

Possibly

1

58

18

2

33

58

1

4

4

14

2

16

53

2

4

32

7

116

179

Definitely 1 1 26 4 18 50
Definitely
4 2 2 9 17
Definitely 3 3 12 11 71 41
141

Total
2 1 31 4 20
58
Total
1 6 6 3 5 15
36
Total
80 96 17 29 142 79
443

36

APPENDIX D COUNTY COMPLIANCE WITH REVIEWING ELIGIBLE DEATHS

Percent of Reviewable Deaths Reviewed, 2001, by County
Note: Counties without a percent had no reviewable deaths for 2001

Dade 50.0

Caloosa 100.0

Walker 0.0

Whitfield 100.0

Murray 50.0

Fannin 100.0
Gilmer 50.0

Union 100.0

Towns 100.0

Rabun 100.0

White Habersham

Chattooga 100.0
Floyd 100.0

Gordon 75.0
Bartow 91.7

Pickens 100.0
Cherokee 100.0

Lumpkin 100.0
Dawson 80.0
Forsyth 100.0

100.0 100.0

Hall

Banks

80.0

0.0

Jackson 0.0

Stephens 100.0
Franklin 100.0
Madison 100.0

Hart Elbert

Polk 0.0
Haralson 0.0
Carroll 27.3
Heard 100.0

Paulding 70.0

Cobb 100.0

Gwinnett 89.9

Barrow 50.0

Clarke
40.0 Oconee

Douglas 14.0

DeKalb 75.8

Walton

Fulton 96.6 Clayton

Rockdale 100.0 Newton

100.0

100.0

50.00
Morgan 100.0

Coweta 75.0

Fayette 0.0

Henry 85.7

Spalding 80.0

Butts 100.0

Jasper

Putnam 75.0

Oglethorpe

Wilkes 100.0

Lincoln

Greene 100.0

Taliaferra

Columbia McDuffie 100.00

Warren 100.0

Richmond

Hancock

72.7

100.0

Glascock

Troup 80.0

Pike

Lamar

Meriwether

Monroe

0.0

100.0

Jones 0.0

Baldwin 100.0

Upson

Harris 0.0

0.0 Talbot

Bibb 50.0 Crawford

Wilkinson 0.0

Twiggs

0.0

Muscogee 94.1
Chattahoochee 100.0

Marian 100.0

Taylor
Schley 0.0

Macon 0.0

Stewart 100.0

Webster

Sumter 50.0

Peach 75.0
Houston 100.0

Bleckley 100.0

Dooly

Pulaski 0.0

Dodge 0.0

Crisp

Wilcox

Quikman

100.0

100.0

Randolph 100.0

Terrell 0.0

Lee

Turner

Ben Hill

Washington 0.0

Jefferson 0.0

Laurens 00.0

Johnson
Treutlen 0.0

Emanuel 0.0

Montgomery

Wheeler

Toombs

00.7

Telfair 100.0

Jeff Davis 0.0

Appling 80.0

Burke 0.0

Jenkins

Screven 100.0

Candler 100.0

Bulloch 100.0

Effingham 0.0

Evans 0.0
Tallnall 100.0
Lang

Bryan 25.0
Liberty 100.0

Chatham 80.0

Clay

Calhoun

Dougherty 100.0

Early 100.0
Miller 0.0

Baker

Mitchell 100.0

Seminole 100.0

Decatur 25.0

Grady 100.0

Worth 100.0

Tift 100.0

Irwin 100.0

Coffee 100.0

Colquitt 100.0

Berrien 0.0

Atkinson 0.0

Coak 0.0
Lanier

Thomas 0.0

Brooks 100.0

Lawndes 100.0

Clinch Echols

Bacon 0.0
Ware 80.0

Wayne 0.0
Pierce 0.0
Brantley 0.0

McIntosh 100.0
Glynn 00.0

Charltan

Camden 100.0

37

APPENDIX E 2001 CHILD FATALITY REVIEWS, BY COUNTY, BY AGE GROUPS
Appendix E presents county level data for the Child Fatality Review process in 2001. The data is presented for four age groups (infants less than 1 year old, children from 1 to 4 years of age, children 5 through 14, and teenagers ages 15 through 17). Four numbers are provided for each age group: Total Deaths: The total number of deaths (all causes) for that age group. This number is based on Georgia death certificate data and only includes deaths to Georgia residents under the age of 18. This does include deaths of Georgia residents that occurred in other states and were reported back to Georgia, but it does not include deaths of out-of-state residents that occurred in Georgia. Eligible Deaths: The number of SIDS, unintentional, or violence-related deaths (eligible deaths) according to the death certificate classifications. Although other deaths due to medical or natural causes may be eligible for review according to OCGA 19-15-3(e), SIDS deaths are explicitly required to be reviewed, and unintentional/violence related deaths should be reviewed as "sudden or unexpected deaths." Thus, this number represents a minimum number of deaths that should be reviewed. This is a subset of total deaths (DTH). Eligible Deaths Reviewed: The number of SIDS, unintentional, or violence related deaths that were reviewed. This number is a measure of how well a county identified and reviewed the minimum number of appropriate deaths. This is a subset of the total "eligible" deaths. Total Deaths Reviewed: This is the total number of child deaths in 2001 for which a Child Fatality Review Report was submitted. It includes deaths due to medical causes (other than SIDS) in addition to those deaths which were identified as eligible for review. This is based on the county of residence identified from the death certificate.
38

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Appling

533

11

Atkinson

311

5

Bacon

12

3

Baker

0

Baldwin

11 2 2 2 17

Banks

112

Barrow

4

116

Bartow

8 4 1 5 18

Ben Hill

2

1

3

Berrien

2

013

Bibb

36 3 9 7 55

Bleckley

1

012

Brantley

1

012

Brooks

112

Bryan

11125

Bulloch

6 1 1 3 11

Burke

111

3

Butts

3

036

Calhoun

1

0

1

Camden

51017

Candler

3

2

5

Carroll

9 6 3 6 24

Catoosa

61018

Charlton

3

0

3

Chatham

40 3 7 1 51

Chattahoochee 3

0

3

Chattooga

210

3

Cherokee

8 2 3 5 18

Clarke

9 2 4 3 18

Clay

0

Clayton

35 3 8 6 52

Clinch

0

Cobb

84 14 11 11 120

"Reviewable" Deaths <1 1-4 5-14 15-17 Total

"Reviewable" Deaths Reviewed <1 1-4 5-14 15-17 Total

122

5

110

2

2

2

0

1

214

112

2

114

5 1 1 5 12

0

011

3

6 6 15

011

011

112

1124

1124

10

1

1

034

0

011

2

2

1 4 0 6 11

1012

0

6

5 1 12

1

0

1

110

2

11147

1

135

0

4 2 2 3 11

0

5 9 4 6 24

121

4

0

0

0

1

214

0

1

1

2

5 1 1 4 11

0

0

2

428

011

0

112

1

1

1124

0

1

034

0

011

2

2

1

023

1012

0

6

4

10

1

0

1

110

2

11147

1

012

0

4 2 2 3 11

0

5 9 4 6 24

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

31

4

0

0

0

21216

0

1

1

2

5 2 1 5 13

0

0

3

328

1

012

0

112

1

1

1124

0

1

034

1

0

1

1

012

2

2

21025

1012

0

7

6

13

1

0

1

110

2

11147

3

014

0

5 3 4 3 15

0

8 12 6 6 32

39

40

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene

7 1 2 3 13

4 2 1 3 10

4 1 4 3 12

210

3

6

4

10

2

0

2

6 2 2 1 11

21025

3

036

6

3

9

90 10 14 15 129

42129

4

0

4

19 5 0

24

14 1 4

19

310

4

0

31217

0

4 4 2 1 11

310

4

3

115

3 6 3 3 15

11 2 0 3 16

10 2 3

15

3

216

99 15 22 21 157

1

023

1

0

1

16 1 1 2 20

31116

41128

11114

"Reviewable" Deaths <1 1-4 5-14 15-17 Total

"Reviewable" Deaths Reviewed <1 1-4 5-14 15-17 Total

2

1

1

1

2

110

1

3

111

0

2

0

2

2

11 6 6

1

220

313

1

0

11

140

110

2

0

22

520

412

1

2

23 13 8

0

3

0

111

111

1

36 13 35
2 4 0 14 22 35 4 10 33 23 0 4 7 1 0 13 0 16 2 13 37 3 10 7 14 15 59 22 0 25 14 3 1

2

1

1

1

2

3

111

0

1

0

1

0

10 3 3

220

10

1

0

2

0

520

412

1

2

22 12 8

0

2

0

11

111

1

36 13 35
0 3 0 14 11 34 1 9 25 0 0 4 1 1 0 0 0 0 0 13 0 3 10 7 14 15 57 11 0 13 13 3 1

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

2

136

2

114

21227

0

3

3

0

12216

1

1

1

034

0

16 6 7 9 38

0

0

410

5

0

110

2

0

0

0

0

0

2

013

0

5 2 0 3 10

413

8

1

315

28 13 13 19 73

011

0

2

013

1113

211

4

1

1

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie McIntosh Meriwether

70 15 15 10 110

410

5

29 4 4 4 41

1

1

2

6

039

21115

1

0

1

4

0

4

18 1 6 2 27

19 2 3 1 25

3

0

3

7 2 0 1 10

1

1

2

3

1

4

411

6

1

0

1

1

0

1

21115

2

0

2

1

0

1

51118

1

1

2

11 5 1

17

0

1

0

1

24 1 2 6 33

120

3

112

4

21115

110

2

8

0 2 10

1

012

220

4

"Reviewable" Deaths

"Reviewable" Deaths Reviewed

<1 1-4 5-14 15-17 Total

<1 1-4 5-14 15-17 Total

4 10 4 9 27

210

3

5 1 0 4 10

1

1

011

112

0

2

0

2

527

12317

2

0

2

210

3

0

1

1

10

1

0

0

1012

0

0

2

1

3

0

131

5

0

0

3

148

10

1

1

1

1113

10

1

2

013

011

10

1

3 10 4 7 24

210

3

31048

1

1

0

0

0

2

0

2

426

12317

2

0

2

0

0

0

0

0

0

0

0

0

1

1

0

131

5

0

0

3

148

10

1

0

1113

10

1

2

013

011

0

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

3 9 4 7 23

210

3

31149

1

1

0

0

0

2

0

2

12429

12418

2

0

2

0

1

1

2

0

0

0

0

0

0

0

123

1

1

2

231

6

0

0

4 1 1 5 11

10

1

0

1113

10

1

1

012

011

0

41

42

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Miller

10

1

Mitchell

420

6

Monroe

6

017

Montgomery 1

0

1

Morgan

21014

Murray

6

2

8

Muscogee

58 7 6 3 74

Newton

7 3 0 1 11

Oconee

3

227

Oglethorpe

3

0

3

Paulding

8 1 4 3 16

Peach

411

6

Pickens

3

115

Pierce

10

1

Pike

1

0

1

Polk

210

3

Pulaski

10

1

Putnam

7

119

Quitman

10

1

Rabun

3

0

3

Randolph

1

2

3

Richmond

31 4 4 7 46

Rockdale

521

8

Schley

12

3

Screven

2

1

3

Seminole

1

023

Spalding

952

16

Stephens

23016

Stewart

1

0

1

Sumter

613

10

Talbot

111

3

Taliaferro

1

0

1

Tattnall

2

1

3

"Reviewable" Deaths

"Reviewable" Deaths Reviewed

<1 1-4 5-14 15-17 Total

<1 1-4 5-14 15-17 Total

10

1

110

2

1

012

0

1012

2

2

4

10 1 3 3 17

12014

224

0

3 1 4 2 10

211

4

112

10

1

0

10

1

10

1

2

114

10

1

1

0

1

2

2

5

1 5 11

111

3

1

1

1

1

022

131

5

3014

1

0

1

112

4

0

0

1

0

1

0

110

2

1

012

0

1012

1

1

2

9 1 3 3 16

12014

2

2

0

21317

2

1

3

112

0

0

0

0

1

113

10

1

1

0

1

2

2

3

148

111

3

0

1

1

022

130

4

3014

1

0

1

110

2

0

0

1

0

1

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

0

220

4

1

012

0

1012

1

1

2

11 1 3 3 18

12014

2

2

0

11316

2

1

3

1

1

0

0

0

0

1

2

3

10

1

1

0

1

2

2

6 1 2 4 13

111

3

0

1

1

022

140

5

3014

1

0

1

311

5

0

0

1

0

1

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth

2

0

2

1124

1

113

11

1 2 14

5

2

7

3

126

1

012

3

0

3

10 2 1 4 17

111

3

2

013

2

046

1

2

3

510

6

5

0

5

4

3 3 10

0

2

2

7 2 2 2 13

0

0

31116

17 4 2 3 26

1

0

1

2

024

2

3

5

3

014

"Reviewable" Deaths

"Reviewable" Deaths Reviewed

<1 1-4 5-14 15-17 Total

<1 1-4 5-14 15-17 Total

0

1023

112

2

114

1

1

123

011

1

0

1

21036

0

011

2

035

1

1

2

110

2

0

1

315

0

2

2

1

124

0

0

1

113

32139

0

022

3

3

1

0

1

0

1023

0

0

1

1

112

011

0

21025

0

0

2

035

0

0

0

1

214

0

0

0

0

0

1

113

32139

0

022

0

1

0

1

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

0

11024

0

0

1

1

1

1

011

0

2

024

0

0

2

035

0

0

21

3

1

315

0

0

0

0

0

1

113

3 5 1 3 12

0

022

0

2

0

2

Georgia Total *

1141 203 236 219 1799

178 111 130 174 593

Total Deaths Reviewed is based on the review county for the CFR.

143 81 90 129 443

185 103 117 132 537

43

APPENDIX F DEFINITIONS OF TERMS AND ABBREVIATIONS USED IN THIS REPORT

A-A African-American
Child Abuse Protocol Committee County level representatives from the office of the sheriff, county department of family and children services, office of the district attorney, juvenile court, magistrate court, county board of education, office of the chief of police, office of the chief of police of the largest municipality in county, and office of the coroner or medical examiner. The committee is charged with developing local protocols to investigate and prosecute alleged cases of child abuse.
Child Fatality Review Report A standardized form required for collecting data on child fatalities meeting the criteria for review by child fatality review committees.
Child Fatality Review Committee County level representatives from the office of the coroner or medical examiner, county department of family and children services, public health department, juvenile court, office of the district attorney, law enforcement, and mental health.
Eligible Death Death meeting the criteria for review including death resulting from SIDS, unintentional injuries, intentional injuries, medical conditions when unattended by a physician, or any manner that is suspicious or unusual.
Form 1 A standardized form required for collecting data on all child fatalities by corners or medical examiners.
Injury Refers to any force whether it be physical, chemical (poisoning), thermal (fire), or electrical that resulted in death.
Intentional Refers to the act that resulted in death being one that was deliberate, willful, or planned.
Medical Cause Refers to death resulting from a natural cause other than SIDS.
Natural Cause Refers to death resulting from an inherent, existing condition. Natural causes include congenital anomalies, diseases of the nervous system, diseases of the respiratory system, other medical causes and SIDS.

"Other" Race Refers to those of Asian, Pacific Islander, or Native American origin.
"Other" as Category of Death Includes deaths from suffocation, choking, poisoning, and falls (unless otherwise indicated).
Perpetrator Person(s) who committed an act that resulted in the death of a child.
Preventable Death One in which with retrospective analysis it is determined that a reasonable intervention could have prevented the death. Interventions include medical, educational, social, legal, technological, or psychological.
Reviewed Death Death which has been reviewed by a local child fatality review committee and a completed Child Fatality Review Report has been submitted to the Georgia Child Fatality Review Panel.
Risk Factor Refers to persons, things, events, etc. that put an individual at an increased likelihood of dying.
Georgia Child Fatality Review Panel An appointed body of 16 representatives that oversees the county child fatality review process, reports to the governor annually on the incidence of child deaths, and recommends prevention measures based on the data.
Sudden Infant Death Syndrome (SIDS) Sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. In this report, SIDS is not considered a "medical" cause.
Trend Refers to changes occurring in the number and distribution of child deaths. In this report, the actual number of deaths for each cause is relatively small for the purpose of statistical analysis, which causes some uncertainty in estimating the risk of death. Therefore, caution is advised in making conclusions based on these year-to-year changes which may only reflect statistical fluctuations.
Unintentional Death Refers to the act that resulted in death being one that was not deliberate, willful, or planned.

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