New Hampshire’s SUID Project: Collaboration between public health and a state medical examiner’s office to reduce infant deaths

The New Hampshire Department of Health and Human Services' Division of Public Health Services' Maternal and Child Health Section (MCHS), and the New Hampshire Department of Justice, Office of Chief Medical Examiner (OCME), work in partnership through the New Hampshire SUID Case Registry Project, funded by the Centers for Disease Control (CDC).

The NH SUID Project staff consists of the Project Coordinator, from MCHS, the OCME Project Data Clerk and OCME liaison/Chief Forensic Investigator, with assistance from MCHS staff in data analysis. Through NH RSA 611-B, the OCME has the authority to request and collect information for the infant death investigation. Data elements are collected by the Data Clerk through written request and case discussion at the multi-disciplinary state-level SUID Review Group meetings, and are entered into the National Maternal and Child Health Center for Prevention of Child Death Review's web-based data registry. Data are analyzed by the CDC and the state project to identify and monitor trends and risk factors. The enhanced data collection provides more comprehensive case information to the OCME. Data from the registry, with discussion from the Review Group meetings, have helped identify specific populations to target in risk reduction strategies such as a state Safe Sleep Campaign with activities such as an October 2013 Safe Sleep Symposium, a traveling conference display board, and targeted training and dissemination of handouts to perinatal health professionals and home visiting program staff. Recommended policy changes include adding pacifier use to the OCME death scene investigation form, consistent documentation of rectal temperature of the infant, and increased doll re-enactments.

The project provides an opportunity for two state agencies to work together to support more informed decision-making by the OCME, with regard to assignment of cause and manner of death; allow public health to have access to and utilize data to identify and monitor trends and risk factors; and institute a foundation for planning strategies and interventions that may further reduce infant deaths.

Describe how a public health agency and a state medical examiner's office can collaborate to identify sudden unexpected infant deaths in a timely manner and collect comprehensive quality data to track and monitor demographic trends and risk factors associated with SUID for local and national use in developing actionable prevention strategies to decrease further deaths.