The Socio-Demographic Characteristics of Children Who Die from Medical Neglect and Their Families: A Comparative Analysis

Background and Purpose:

About 1,700-2,000 children die annually in the U.S. from maltreatment. Annual statistics from the U.S. Department of Health & Human Services, show that most children die from physical neglect, followed by physical abuse, and then medical neglect. Recent deaths in Idaho and other parts of the nation have thrust medical neglect (MN) into the spotlight, yet little research has focused on children who experience this type of victimization. This study uses the National Child Abuse and Neglect Data Set (NCANDS) to investigate the characteristics of children who die from MN and the characteristics of their families, in comparison to children who die from physical abuse or physical neglect.

Methods:

This study uses NCANDS to conduct a comparative analysis of fatal child maltreatment victims by maltreatment type. NCANDS captures information from all children and families who encountered the child welfare system in a given year. The sample begins with over 3 million cases, but is restricted to only fatality cases, and compares deaths where children died from MN (n=28) with other maltreatment types (n=1048). Given the small sample size of the MN victims, descriptive and bivariate analyses were conducted on child, parent, and household risk factors. This analysis is the first time that NCANDS has been used to examine MN-based deaths.

Results:

Children who die from MN are older than other fatality victims, but not significantly so (p=.319). Cross-tabulations showed that MN victims were generally from homes which presented with fewer problems in the areas of parental alcohol problems (0% vs. 8%), domestic violence (8% vs. 14.5%), inadequate housing (14.3% vs. 24.6%), and public assistance (13.3% vs. 25.6%). But, fatal victims of MN had caregivers who presented with more problems in the areas of emotional distress (20% vs. 6.1%) and drug addiction 26.1% vs. 17%).

Conclusion and Implications:

This study provides the first use of the NCANDS data to examine how fatal victims of MN compare with fatal victims from physical abuse and physical neglect. The results show that victims of MN have caregivers who may be more likely to struggle with drug addiction and mental health concerns, but not other areas of concern. This paper speaks to current events in the USA concerning denying children medical treatment in selected communities and states and also to the opioid epidemic and how this may place children at increased risk for fatal maltreatment. The results of this study provide important information for practitioners in the field and provide implications concerning treatment and funding of services.