By Anita Wadhwani, The Tennessean
A total of 802 children died in Tennessee in 2011, with a third of
those deaths a result of abuse, murder, drowning, suicide, suffocation
or other preventable causes, according to new data released Tuesday by
the Department of Health.
State health officials note it is the fewest number of child deaths they have had to report in the past five years.
Still,
the new data are unlikely to shake Tennessee's grim foothold on the top
10 list for states in the country with the highest child death rates.
Children
are more likely to die in Tennessee before they reach their 18th
birthday than in most other states, surpassing the national average of
52 deaths for every 100,000 children. In Tennessee, the average was
closer to 66 deaths per 100,000 children, according to U.S. Centers for
Disease Control and Prevention data for 2010, the most recent year that
national comparison data are available. By 2011, child deaths claimed 60
of every 100,000 Tennessee children.
"While we are pleased to
have made improvements in the review process and progress in most areas
of reducing deaths, we remain disturbed that too many of our children
are dying from preventable causes," said Dr. John Dreyzehner,
commissioner of the Department of Health.
"Most preventable child
deaths involve complex societal and medical challenges, requiring a high
level of collaborative efforts to make more significant differences,"
he said.
The state's annual report on child mortality comes amid
increasing concern by lawmakers, child advocates and others about the
role of the state's Department of Children's Services in investigating
reports of abuse or neglect for children who later died. The controversy
prompted former DCS Commissioner Kate O'Day to step down from her job
earlier this month.
The Department of Health report released
Tuesday noted that 38 children were subjects of open DCS investigations
at the time of their deaths.
However, DCS spokeswoman Molly
Sudderth said she could not confirm the number of children who died in
2011 who were subjects of DCS investigations. Those deaths are "under
review," she said. Sudderth said she could confirm only that 14 children
who were in the physical custody of DCS died that year.
The
department has conceded it has misreported child death numbers at least
four times in the past six months. On Tuesday, Sudderth said agency
officials hope to be able to give an accurate count soon.
Some progress
The report notes that the state's child death rates have dropped 20
percent between 2007 - when 1,087 child deaths were reported - and 2011.
The
report attributes drops in child deaths to a 16.8 percent decrease in
sleep-related infant deaths due to suffocation and strangulation.
The
report also notes that the state saw a 20 percent drop in the number of
African-American child deaths in the same time period. But black
children continue to be more vulnerable to deaths than children of any
other race in Tennessee, according to the report.
And babies are
still more likely to die than any other age group, accounting for 62
percent of all child deaths reported in 2011.
"The first year of life continues to be the most perilous for Tennessee's children," the report notes.
Tennessee's
high child death rate is not due to any single factor, but many of its
causes can be traced back to poverty, drug abuse and mental health
problems, said Linda O'Neal, executive director of the Tennessee
Commission on Children and Youth. She also serves on the statewide Child
Fatality Review Team, which analyzed the child death data.
"I
think one of the factors is violence, which is related often to
substance abuse and mental health issues," she said. "While we rank high
in these numbers, we put some of the least amount of state dollars into
substance abuse treatment per capita of any state.
"Poverty is
high in the state, with a little over one in four children living in
poverty. And the stress of poverty, inadequate housing and other
stresses in the families can contribute to substance abuse, mental
health and child abuse."
3 recommendations
The report makes three recommendations to prevent future tragedies.
First,
state officials recommend an "aggressive campaign to educate infant
caregivers in every county of the state on safe sleep practices, with a
particular goal on reducing racial disparities." The Department of
Health recommends distributing 80,000 brochures or pamphlets giving
advice on how to properly put children to sleep.
The report also
recommends more presentations to middle and high school age children on
safe driving. Children 10-17 account for nearly two-thirds of all
children who die in motor vehicles, according to the report.
And,
the report recommends more active participation by state experts in
guiding child fatality review teams in each of Tennessee's 39 judicial
districts in more thoroughly and accurately reviewing child deaths.
Child
deaths are first reviewed by these local teams, which include
representatives from DCS, police and others, who are charged with
learning and reporting as many details about child deaths as they can to
state officials.
But their reports are sometimes lacking.
Although DCS is represented on each fatality team, an earlier draft of
the child death report noted that in more than 170 child deaths, there
were no notes from DCS or others on whether the agency had been involved
in the child's family before the child's death.
Those were among
the details Department of Health officials spent months tracking to
complete their analysis, according to Dr. Michael Warren, director of
maternal and child health for the department.
2011 Tennessee child fatalities
The state child fatality review team examined 799 of the 802 total
child deaths in 2011, with three cases unavailable for review.