2005 Report Mecklenburg County Community Child Fatality Prevention & Protection Team 2005 Annual Report of Infant and Child Deaths Nalini Jones, Team Chairman Dr. Stephen Keener, Mecklenburg County Medical Director April 3, 2007 Welcome: Hi I’m Nalini Jones, Local Administrator for the Guardian ad Litem for Mecklenburg County and the Chairman of the Local Child Fatality Prevention and Protection Team. It is my pleasure to come before you tonight to present the 2007 annual child fatality report with 2005 death data. As you may remember from past years, or for those of you who are new to the Board, the child death data that we will present is about 15 months old, this is due to the fact that it takes about one year to analyze the data from the state and make sure that it is accurate. Regardless of the age of this data, the trends have remained about the same, and that is what concerns us and what we’ll talk about the most tonight. These trends must end in order to improve child death outcomes in our community.

Introduction Child Fatality Team overview Why are we reporting to you? Members of the team So what does the data show… Each county in the state of North Carolina is mandated by State Statute in May 1991 to establish a multi-disciplinary, community team to review child deaths that include child abuse and neglect, preventable deaths, and other deaths. Our mission is to identify gaps and deficiencies in the comprehensive local child service system, both public and private. And to advocate for prevention efforts in a coordinated manner. We are mandated by statute to make a report to you about our activities for the year, our recommendations for changes in systems as a result of our findings, and work collaboratively as a team to raise issues about how to protect children from preventable injuries and death. Members of our team include but are not limited to, local non-profit youth serving agencies, health providers such as CHS, Presbyterian and the Health Department, DSS Fire and Police, state agencies such as GAL & the Courts, MEDIC and mental health agencies.

Goals, Results, Plans 2006 Goals 2006 Results 2007 Plans Educate parents on safe sleep for infants Encourage safekeeping for guns Support motor vehicle safety 2006 Goals Produced a Child Safety Resource Guide Collaborated county-wide on safety issues Strengthened awareness of our 2006 goal areas 2006 Results Give overview of this slide and then say: Establish five year strategic plan Continue goals based on injury & death data 2007 Plans Now I will turn over this part of the presentation to Dr. Steve Keener who will give you a breakdown about child deaths in our community

Trend in Infant and Child Deaths Ages Birth through 17 Years Mecklenburg County, 2000 through 2005 In 2005, there were 157 infant and child deaths 112 (71.3%) occurred among infants 45 (28.7%) occurred among children ages 1 to 17 Infant and child deaths had been on the decline until 2004 when the infant mortality rate spiked from 6.8 to 9.2 in 2004. This increase in natural deaths among infants accounts for the marked increase from 2003 to 2004. Natural Deaths are deaths that occur from natural disease processes or genetic influences. Examples, of natural causes are prematurity and low birth weight, congenital malformations (or birth defects), conditions originating in the perinatal period, etc. The top three leading causes of death for infants in Mecklenburg County are natural deaths.

Annual Infant Mortality Rate per 1,000 Live Births Mecklenburg County, 2000 through 2005 Child and infant death rate is dependent on the infant mortality rate Majority of infant deaths are natural deaths The leading cause of death for infants is prematurity and low birth weight

Percent of Infant Deaths (<1 yr) by Cause of Death (N=112) Mecklenburg County, 2005 Infants die more often of natural deaths than children 45% of all unintentional injuries occurred among infants All 9 unintentional injury deaths were due to accidental suffocation Deaths due to unsafe sleeping arrangements (co-sleeping) and inappropriate bedding (soft sleep surface, loose bedding) continues to be a problem in Mecklenburg County. All 9 accidental suffocation deaths among infants were due to unsafe sleeping arrangements and/or inappropriate bedding. In the cases of unsafe sleeping arrangements there was a separate crib for the infant present but not being used.

Percent of Childhood Deaths Ages 1 to 17 by Cause of Death (N=45) Mecklenburg County, 2005 Children ages 1 to 17 dies more often from Motor vehicle injuries, homicides, and than infants Natural deaths include cancer, infectious disease, heart disease, and disease of the nervous system and endocrine system

Deaths Due to Homicides and Suicides Among Infants (<1 yr Deaths Due to Homicides and Suicides Among Infants (<1 yr.) and Children Ages 1 to 17 Mecklenburg County, 2000 through 2005 There were 10 homicides and 2 suicides in 2005 80% of homicides occurred among children There were 7 homicides among teens and 6 involved firearms There were two suicides (16 & 17)

Deaths Due to Unintentional Injuries Among Infants (<1 yr Deaths Due to Unintentional Injuries Among Infants (<1 yr.) and Children Ages 1 to 17 Mecklenburg County, 2000 through 2005 In 2005, 8 deaths were due to MV injuries & 5 were among teens 50% of all unintentional injuries were accidental suffocations Unintentional injuries are the leading cause of death among children & young adults

Deaths due to SIDS decreased from 9 in 2004 to 5 in 2005 Death Rates from Sudden Infant Death Syndrome (SIDS) Mecklenburg County, North Carolina, and the United States 1998 through 2005 Deaths due to SIDS decreased from 9 in 2004 to 5 in 2005 SIDS deaths associated with co-sleeping and inappropriate bedding One SIDS death occurred among a child 1 year of age Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant less than one year of age that cannot be explained by information collected during a through investigation including an autopsy, examination of the death scene, and a review of the clinical history of the infant. While the cause of SIDS is unknown there are several risk factors associated with SIDS that can help reduce the risk of dying from SIDS: Tummy (prone) or side sleeping Soft Sleep Surfaces Loose bedding Overheating Smoking Bed sharing Prematurity and low birth weight infants

Safety Accomplishments Collaborated on county-wide safety projects Support MEDIC request for more EMS vehicles Support increases for infrastructure of safety agencies Open communication with community agencies

Keeping Children Safe & Healthy Continue funds for more school nurses Support staff for the Team Commissioner Woodard Support for District Attorney Work with State on strong laws Thank you! Dr. Keener will turn the presentation back to you. First of all, thank you for taking the time for us to come and talk to you tonight. One of our projects this year has been to have a team representative come each month to let you know that we are working to find ways to reduce childhood deaths and to inform you of the problem. There are a number of items that you can help with to keep children safe in Mecklenburg County. These are just a few examples: Last year you proved for 20 more nurses in schools, please continue that trend so that children have that basis need met during their school day. DSS & the Health Department provide staff for the team and we thank you for that support. Commissioner Woodard has been a great asset to us as your designee to the team. Please continue to support the district attorney with needed resources for his office to prosecute the offenders in child death cases. As the state strengthens laws to keep children from being injured or dying, we may ask for your support, which I hope we can count on. And thank you once again for your efforts to protect children!