Child Death Reviews and Child Mortality Data Collection in Canada

Prepared by

Jan Christianson-Wood,MSW,
RSW Jane Lothian Murray,MA
French Editor:Ginette Abraham,MSW
1999

Financial support for this work was received from:
Child Maltreatment Division,
Bureau of Reproductive and Child Health,
LCDC Health Canada

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Table of Contents

• Part I: Executive Summary
• Part II: Introduction
  • The Problem
  • The Project
• Part III: An Overview of Research on Child Maltreatment Deaths in Canada
  • Canadian Data and Research on Child Deaths
  • Injury Statistics and Injury Prevention Research
  • Injury Prevention Research
  • U.S. Research on Child Deaths
• Part IV: The Child Mortality Analysis Project
  • Research Design and Methodolgy
  • Limitations of the Data
• Part V: Findings and Discussion
  • Part 1 Data Management Systems
  • Part 2 Data Collection
  • Child Death Investigations and Existing Review Bodies in Canada

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Executive Summary

At present, there are no comprehensive Canadian statistics on the incidence of child abuse and neglect deaths. In conducting research into child abuse and neglect fatalities, it became obvious that definition is both a critical factor for success and a current barrier to accurate counting of child maltreatment deaths in Canada. Efforts in the USA have had similar results as there are 50 states counting fatalities in ways that are sufficiently different to make a national count a difficult task.

Canada's twelve Chief Coroners and Chief Medical Examiners meet yearly to consider these and other issues with respect to their own work. The twelve Directors of Child Welfare in Canada also have regular meetings to discuss issues of common interest. The provincial Child Advocates in Canada also have regular contact around issues of policy and practice. These systems, plus the existence of a national organization of Chiefs of Police, offers hope that Canadians may be able to work together to arrive at an accurate count of the number of Canadian children who die each year from acts of commission or omission by those adults responsible for their well-being. This research is intended to support a better understanding of how child deaths are investigated and counted across Canada. Part of this involved understanding what information is collected by police, Chief Coroners and Chief Medical Examiners, Child Advocates and child welfare at the provincial or territorial level. A survey using a purposive sampling method was chosen as the way to obtain a "picture" of how the deaths of children are dealt with across the country. Interviews with key informants were planned as a means of getting greater detail about the process of dealing with child deaths.

An area chosen for investigation was the use and composition of child death review teams in Canada. These "teams" have been in use for 20 years in the USA and have proven so valuable in ensuring that maltreatment deaths are not misunderstood that their use has spread to Canada and elsewhere. Currently, there are eight such teams in Canada, each with its own unique characteristics designed to provide the best fit with provincial or territorial legislation, population and the needs of each area. The oldest of these teams is only 6 years old and two of the eight were formed in 1998. An examination of these teams, including their composition and function, was included in the research plan.

A lack of common definitions proved to be a barrier in efforts to obtain information about neglect deaths. Some systems found the term offensive, describing it as pejorative. Others collected information about neglect but database limitations made it difficult to retrieve it once it was entered into a file. With few exceptions, the systems surveyed collected and stored a large amount of valuable information on child deaths but technical barriers such as different database structures made the comparing of information difficult if not impossible. The greatest hope lies in the use of "extractable data elements" that would be defined and described using agreed upon terms to enable the collection of child death data on a national level. With few exceptions, willingness to do this was evident—even the exceptions arose more from scarce resources than from a belief that there was no point in conducting research into child maltreatment deaths.

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Child Death Reviews and Child Mortality Data Collection in Canada