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Infant injury deaths with unknown intent: what else do we know?
M D Overpeck1, R A Brenner, A C Trumble
1Division of Epidemiology, Statistics, and Prevention Research at the National Institutes of Child Health and Human Development, Bethesda, MD 20892, USA. Mary_Overpeck@nih.gov
Summary
Child homicide rates are underestimated. Including undetermined intent deaths, which resemble intentional cases, could increase injury homicide rates by nearly 20%.
Area of Science:
- Public Health
- Epidemiology
- Child Safety
Background:
- Child homicide is a significant public health concern.
- Official statistics may underestimate the true incidence of infant homicides.
- Infant injury fatalities with undetermined intent warrant further investigation.
Purpose of the Study:
- To compare characteristics of infant injury fatalities with undetermined intent to those of intentional and unintentional deaths.
- To assess the probability that undetermined intent fatalities should be classified as homicides.
- To evaluate the impact of including undetermined intent deaths on overall homicide rates.
Main Methods:
- Utilized linked US birth and death certificates (1983-1991).
- Identified injury fatalities categorized as intentional, unintentional, or undetermined intent.
- Analyzed maternal and infant variables associated with injury fatalities and calculated relative risks.
Main Results:
- Infants of mothers with lower education, no prenatal care, young age, or single status had higher risks across all intent categories.
- Undetermined intent fatalities showed higher relative risks in high-risk categories compared to intentional or unintentional.
- Risk profiles for undetermined intent deaths more closely resembled intentional deaths.
Conclusions:
- Including undetermined intent deaths could increase reported injury homicide rates by nearly 20%.
- Excluding undetermined intent deaths may lead to underestimation of infant intentional injury.
- Misclassification and under-ascertainment of homicides may be more widespread than official data suggest.