Coroner-reviewed infant and toddler deaths. Many "undetermineds" resemble homicides

Although homicide is a leading cause of death of infants and toddlers, there is some suspicion that an unknown number of additional deaths are unrecognized homicides. The authors used California mortality data from 1969 to 1991 to examine 12,246 injury deaths that occurred before age 5. Characteristics of the dead child, injury event, and postmortem were compared for accidents, homicides, and undetermined deaths. A logistic model was developed to differentiate homicides from accidental deaths and then was used to predict whether undetermined deaths were likely to be homicides or accidents. Unlike accidental deaths, undetermineds and homicides had similar distribution patterns of age, race, sex, and place of injury. The predictive model indicates that 43.8% of the undetermined injury deaths were similar to homicides on several characteristics. True rates of homicide for infants and toddlers may, unfortunately, be nearly one fifth and one tenth higher, respectively, if the undetermined deaths that resemble homicides are taken into account.