title: History of maltreatment among unintentional injury deaths: analyses of Texas child fatality review data, 2005-2007.
abstract: OBJECTIVE
  This report examines unintentional injury deaths among children with and without a history of child maltreatment.
  
  
  METHODS
  Data are from reviews of 1192 unintentional injury deaths occurring among children in Texas during 2005-2007. The study examined differences in child demographic characteristics, injury mechanism, and supervisor status at time of death between children with and without maltreatment history by using descriptive statistics and χ² tests. Separate analyses compared characteristics of asphyxia, drowning, and poisoning deaths.
  
  
  RESULTS
  In 10% of the unintentional injury deaths that were reviewed, the child had a history of maltreatment. The prevalence of a history of maltreatment was highest among black decedents and lowest among white decedents. Prevalence of a history of maltreatment was highest among infant decedents and lowest among youth decedents, ages 10-14 years. Among deaths where there was no maltreatment history, 54% were due to motor vehicle related incidents, whereas 51% of deaths among children with maltreatment history were caused by drowning, asphyxia, and poisoning. Supervisors of child decedents with a history of maltreatment were significantly more likely to have been alcohol impaired (6.9% vs 1.6%; p<0.0005), or asleep (12.1% vs 6.6%; p=0.03) at the time of death. Differences between child decedents with and without maltreatment history were observed in infant sleep surface in suffocation deaths, location and barrier type in drowning deaths, and substance type in poisoning deaths.
  
  
  CONCLUSIONS
  These data show that the mechanisms and circumstances surrounding unintentional injury deaths among children with a history of maltreatment differ from those without a history of maltreatment. This underscores the need for appropriate interventions to prevent unintentional and intentional injuries in families with a history of maltreatment.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, GA, USA. Svp2@cdc.gov
authors.forename: Sharyn E
authors.initials: SE
authors.lastname: Parks
authors.forename: Gita
authors.initials: G
authors.lastname: Mirchandani
authors.forename: Susan
authors.initials: S
authors.lastname: Rodriguez
authors.forename: John
authors.initials: J
authors.lastname: Hellsten
mesh_terms: D000059:Accidents / Q000401:mortality*; D000293:Adolescent; D017677:Age Distribution; D044383:Black People / Q000706:statistics & numerical data; D017028:Caregivers; D002423:Cause of Death; D002648:Child; D002649:Child Abuse / Q000208:ethnology / Q000401:mortality* / Q000517:prevention & control; D002675:Child, Preschool; D003644:Death Certificates; D005191:Family Characteristics; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D017678:Sex Distribution; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000208:ethnology / Q000401:mortality* / Q000517:prevention & control; D001741:Black or African American