Child deaths from abuse and neglect
June 2012

In this paper we provide an overview of the magnitude of child deaths due to child abuse and neglect in Australia and set these statistics in an international context. For other statistically based CFCA Information Exchange resources, see: Child Abuse and Neglect Statistics, Children in Care and Economic Costs of Child Abuse and Neglect.

Child deaths from abuse and neglect are deaths resulting from acts of physical violence or neglect of a child that are perpetrated by a family member or caregiver. In this paper we define a child as being under the age of 18 years.

What international statistics are available?

The World Health Organization (WHO) has estimated that every year there are 31,000 homicide deaths in children under the age of 15 (WHO, 2010). In their 2006 report, WHO estimated that violence related deaths were almost twice as high in low-income countries (2.58/100,000) than in high-income countries (1.21/100,000) (WHO, 2006). UNICEF (2003) estimates suggested that of the 27 most economically developed nations, Australia had the 9th lowest rate of child death resulting from maltreatment for children under 15 years of age in the 5 year period from 1994-98. While Australia's rate, 0.8 per 100,000 children, is approximately 4 times the rate in Spain, Greece and Italy, it is below the rates in New Zealand (1.3) and the USA (2.4).

These figures are likely to under-represent the actual numbers of deaths however. Mortality statistics rely on the accurate and complete capture of all deaths within a defined population. In high-income countries with well-developed systems, birth and death registration processes ensure statistics are produced in a routine, systematic manner. In addition to this, death certification relies on doctors or coronial reviews to assign a cause of death. In low-income countries there may be some births that are not registered and cause of death may be assigned by a doctor, but where a doctor was not present, certification is reliant on verbal autopsy after the fact or in some cases may be assigned by trained medics or tribal elders. In some circumstances the death may only be captured during community surveys. The Global Burden of Disease Project has found that death registration data are available for 83 countries (28% of the global population) and high quality data were only available for 20 countries (Bhalla, Harrison, Shahraza, & Fingerhut, 2010).

Research has consistently found that the youngest children are the most vulnerable to abuse and neglect related deaths. For example, a recent study in the United States found that 79.8% of child deaths were in children younger than 4 years of age with 47.7% deaths under the age of 12 months (US Department of Health and Human Services, 2011).

In countries with well-developed death registration systems child death review systems have evolved to provide additional information necessary to understand and prevent child deaths.

What information is available in Australia?

In Australia, all deaths are registered at a state level by the Registrar for Births, Deaths and Marriages. Statistics are compiled and reported by the Australian Bureau of Statistics. There is however, no national report on causes of death for all Australian children under the age of 18.

According to the most recent national data, between 2004 and 2006, the leading cause of death among children aged 0-14 years was injury. In 2006, assault was the third most common type of injury causing death for Australian children aged 0-14 years after transport related deaths and drownings. Of the 241 Australian children who died in 2006, 27 were due to assault related injury, compared to 66 deaths of children from transport accidents and 46 drowning deaths (Australian Institute of Health and Welfare, 2009). A 2003 report by the Australian Institute of Criminology estimated that, on average, 25 Australian children are killed by their parents each year (Mouzos & Rushforth, 2003).

Research has demonstrated that because routine data are collected for different reasons (Stone et al., 1999), individual databases are likely to under-represent the numbers of fatal child maltreatment (Schnitzer, Covington, Wirtz, Verhoek-Oftedahl, & Palusci, 2008; Lyman et al., 2004). In order for the cause of death recorded on a death certificate to be attributed to assault or child maltreatment, a doctor or coroner must give those as the underlying cause of death on a death certificate. If there is any uncertainty about the intent of the cause of death then, according to the requirements of the International Classification of Diseases, the death may be assigned to an "accidental cause". This is likely to result in an underestimation of the true magnitude of child maltreatment fatalities. Australian research using hospital morbidity data has shown that almost a third of children admitted to hospital with an unintentional injury are known to child protection authorities (McKenzie, Scott, Fraser, & Dunne, 2011) suggesting that a number of admissions likely to be associated with maltreatment are not recognised as such. Under recognition of maltreatment as a cause is also likely to translate to death data.

Which states carry out child death reviews?

Detailed information on deaths resulting from child abuse and neglect is not available from all Australian jurisdictions; however, information from jurisdictions that carry out official inquiries into child deaths (also referred to as child death reviews) provides some guidance. Child death review teams report on state and territory level data for New South Wales, the Northern Territory, Queensland, South Australia, Victoria and Western Australia.

Child Death Review Teams collate and link data from multiple sources to improve understanding of the circumstances of each child's death. This information is used for the benefit of future prevention and action. They do not aim to determine the culpability of alleged offenders or comment on the individual performance of workers, nor do they investigate the causes of child deaths; that role is left to the police and coroner. In most cases, Child Death Review Teams rely mainly on document and case note analysis, however in some instances teams may conduct interviews or meet with staff or families of the deceased.

Reports released by the child death review teams/committees are described and the available data presented below. For those jurisdictions that do not have a publicly available formal and routine fatal abuse reporting mechanism, a description is provided of any other publicly available review or data on fatal abuse. There is no uniform structure or legislation for child death review team responsibilities. Reporting requirements vary for each state or territory.

ACT

Child death review is conducted for clients known to both Care and Protection Services and ACT Health, however, there are no publicly available recent statistics on child maltreatment related deaths.

New South Wales

 In NSW there are 2 child death review teams who report on child deaths in that state. One provides a review of the causes and patterns of deaths of all NSW children 17 years of age or younger and the other consists of a biennial review of the causes and patterns of deaths of the subgroup of children who died of abuse, neglect, and circumstances suspicious of abuse and neglect and children who died while in care.

The 2010 annual report of the Child Death Review Team provided information on 139 children known to Community Services who died between 1 January and 31 December 2010, of which 33 were identified as Aboriginal. Of the 139 deaths, 13 children and young people died as the result of fatal assault. While over three-quarters of children who died as a result of abuse in NSW between 2003 and 2009 died in family homicides, in 2010 the majority of children who died from fatal assault (seven of the 13) were teenagers allegedly killed by peers. Four children died in familial homicides, one child died following an alleged attack by an acquaintance and one young person was killed in an incident involving unknown assailants (NSW Child Death Review Team, 2010).

In addition to the thirteen fatal assault deaths, half (7) of the young people who died as a result of suicide had been known to child protection services within the 3 years prior to their death; two of these seven had a reported risk issue of neglect and two were in the context of inadequate supervision. Two of the 14 children who died in drowning incidents were similarly known to Community Services, with one child at risk in the context of domestic violence and the other with inadequate supervision.

The NSW Ombudsman's (2011) biennial report of reviewable child deaths reviewed the causes and patterns of deaths of children who died of abuse, neglect, and circumstances suspicious of abuse and neglect and children who died while in care. There were 77 reviewable deaths of children identified as children who died of abuse, neglect, and circumstances suspicious of abuse and neglect or children who died while in care in the 2-year period from January 2008 to December 2009. Of these deaths, 20 children died as a result of abuse, 23 of neglect, 14 in circumstances suspicious of abuse or neglect and 20 while in care.

Northern Territory

The Child Death Reviews and Prevention Committee's Annual Report (2011) provided information on all infant and child deaths registered in the Northern Territory in 2010. Information on whether children were known to child protection services is not recorded in the Northern Territory. Of the 44 registered deaths, 24 (55%) occurred during infancy (first 12 months). Twenty-nine (66%) of the registered child deaths in 2010 were Aboriginal children. The report presented ABS data from 2009 to provide a comparison of the NT and national child death rates; the NT child death rates in all age groups, and specifically in infants, were considerably higher than the national rates. For example, the infant death rate for the NT is 7 per 1,000 live births, while the national average is 4.3 (NT Child Deaths Review and Prevention Committee, 2011).

Queensland

Similar to NSW, there are 2 death review teams that operate in Queensland. Detailed analysis of all deaths of children under 18 years of age in Queensland are provided in the Commission for Children and Young People and Child Guardian's annual report (2011). In the 2010-11 financial year there were 465 child deaths registered in Queensland. Fatal assault and neglect accounted for the deaths of five children (0.5/100,000). Two of the children died at the hands of a family member or parent. Three of the five maltreatment related deaths were children known to the child protection system.

The Queensland Child Death Case Review Committee reviews only those deaths of children known to the child protection system within 3 years prior to their death. In 2010-11 the committee reviewed the deaths of 65 Queensland children and young people, 17 (26%) who identified as Aboriginal. Of the 65 child deaths reviewed, 64 had some association with child protection services prior to their death. One child became known to child protection services due to the circumstances surrounding their death.

During this period, only one child death was attributed to fatal assault, while the previous reporting period of 2009-10 identified five deaths due to fatal assault and neglect (Queensland Child Death Case Review Committee, 2011). Drowning was the leading cause of death (7 deaths) with 5 of these occurring in toddlers between 1 and 4 years of age. Inadequate supervision where the children were not within the direct line of sight of an adult at the time of the incident was determined to be associated with all toddler drownings reviewed in 2010-11. Suicide was the next most common cause of death in these children with 6 deaths (3 in children 10-14 years and 3 between 15 and 17 years).

The report indicated that many of the families of the children and young people whose deaths were reviewed experienced significant issues that impacted on their functioning - including substance misuse, domestic violence, high mobility of lifestyle (transience), mental health conditions, involvement with the criminal justice system, and intellectual and/or physical medical conditions. In 62 (95%) of the families of children and young people reviewed, one or more of these issues were identified as present (Queensland Child Death Case Review Committee, 2011).

South Australia

In South Australia, the Child Death and Serious Injury Review Committee (CDSIRC) reviews circumstances and causes of deaths and serious injuries to children and young people. During the 2010 calendar year, 119 children died in South Australia at a rate of 33.4 per 100,000 (CDSIRC, 2011). Two of these were the result of fatal assault. Thirty-one of the 119 children who died in 2010 had contact with the child protection system in the 3 years prior to their death. Eleven deaths were of Aboriginal children - the death rate for Aboriginal children (90 per 100,000 children) was almost three times higher than the death rate for all children in South Australia (35 per 100,000). The CDSIRC Annual Report 2010-11 covered data for a period of 6 years from 2005-10; during this period 17 child deaths were attributed to fatal assault and five to neglect; of these 12 had contact with the child protection system.

Tasmania

The most recent maltreatment fatality data in Tasmania is from 2005-06. During this time period there were 10 child deaths of children known to the child protection system (Department of Health and Human Services, 2006).

Of these 10 deaths:

  • in two cases, the child protection system was only alerted to the child after his or her death;
  • in three cases, child deaths were classified as resulting from suspected abuse or neglect;
  • in two cases, child deaths resulted from Sudden Infant Death Syndrome; and
  • in three cases, child deaths were attributed to natural causes or as a consequence of disability that was unrelated to the child protection system.

Victoria

The Victorian Child Death Review Committee (VCDRC) reviews reports prepared by the Office of the Child Safety Commissioner relating to services provided to children who were clients of the Child Protection service at the time of their death or within 12 months prior to death. Their Annual Report 2011 provided demographic data and information on trends relating to the deaths of children referred to the Child Safety Commissioner by the Department of Human Services. In addition it provided qualitative analysis of child deaths reviewed by the VCDRC in the reporting period between April 2010 and March 2011.  

In 2010, the Department of Human Services referred 29 cases of children who had died and were known to child protection to the Child Safety Commissioner for inquiry (Victorian Child Death Review Committee, 2011). Of these, three children identified as Aboriginal, 17 children had active child protection case involvement at the time of their death and 12 children were the subject of a child protection case closed within the 12 months preceding their death. Between April 2010 and March 2011, the VCDRC completed 28 reviews of child deaths.

Western Australia

The Ombudsman Western Australia has responsibility for reviewing and investigating child deaths in WA. During the financial year 2010-11 there were 118 child deaths reported to the coroner, of which 24 were identified as Indigenous. The Ombudsman reviews only deaths of children who had contact with the Department of Child Protection in the 2 years prior to death. The circumstances of death in the 118 child deaths in 2010-11 included sudden unexpected death of an infant (34), motor vehicle accident (22), illness or medical condition (17), accident other than motor vehicle (9), suicide (11), drowning (8), alleged homicide (2) and other reasons (15). Of the 118 child deaths, 60 children were known to the Department of Child Protection. However, only 31 cases were considered for review by the Ombudsman (Ombudsman Western Australia, 2011). While the investigation seeks to identify patterns and trends, risk factors and ways to prevent or reduce child deaths, it does not establish the cause of the child's death nor conclusively state whether there is any indication of maltreatment.

Summary

Age appears to be a significant factor in child deaths in all jurisdictions with infants (less than 12 months) accounting for a large proportion of all registered child deaths.  Previous contact with child protection services, often with an intergenerational family history, also featured as a common denominator in child deaths across Australia. The co-occurrence of multiple social and environmental factors in a substantial number of child death incidents in all jurisdictions is also noteworthy. These factors include family and domestic violence, alcohol and drug use and financial disadvantage, especially family homelessness and poverty. 

Despite significant effort at state level to understand deaths associated with maltreatment there is no national collection or compilation of information on all child deaths, including those associated with maltreatment.

Further CFCA reading

References

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Acknowledgements

This paper was updated by Deborah Scott, Research Fellow with the Child Family Community Australia information exchange at the Australian Institute of Family Studies.

Previous editions have been compiled byAlister Lamont, Mel Irenyi, Briony Horsfall, Katie Kovacs and Nick Richardson.

Publishing details

Published by the Australian Institute of Family Studies, June 2012

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