246315 Childhood fatalities in New Mexico: Medical examiner-investigated cases, 2000-2010

Monday, October 31, 2011

Sarah Lathrop, DVM, PhD , Office of the Medical Investigator, University of New Mexico Health Sciences Center, Albuquerque, NM
Amy Wyman, MS , Office of the Medical Investigator, University of New Mexico Health Sciences Center, Albuquerque, NM
Background/Purpose: To evaluate deaths of children in New Mexico investigated by the medical examiner. Methods: We reviewed records of childhood deaths (19 years and younger) between 2000 and 2010 from New Mexico's statewide medical examiner. Autopsies, scene investigations, radiographic imaging and microbiologic testing are included in childhood death investigations in New Mexico. Results/Outcomes: Each year, 313 to 383 childhood deaths were investigated (3822 total). Males were over-represented (62% of deaths). American Indians were also over-represented (20.4%) when compared to New Mexico's population (10%). The most common manner of death was natural (44.9%), followed by accidental (31.3%), homicide (8.8%) suicide (8.8%) and undetermined (4.1%). Infants under one year of age accounted for 41.4% of deaths. Investigations of sudden unexpected infant deaths lead to 57% being attributed to sudden infant death syndrome, 22% to infection and 17% undetermined. Accidental death rates in children decreased from 6.8 per 100,000 in 2002 to 4.2 in 2010. Motor vehicle crashes were responsible for the majority of accidental deaths (68.9%), followed by unintentional overdoses (6.9%) and drowning (5.3%). Gunshot wounds, either intentional or unintentional, caused 9.2% of childhood deaths. Homicide and suicide rates remained constant, but higher than US rates. Nineteen suicides occurred in children under 13 years. Homicides displayed a bimodal distribution, with highest rates in children under one year of age and over 17, with 77% of victims male. Conclusions: Complete medicolegal investigation of childhood fatalities is needed to provide public health agencies with adequate data to evaluate and prevent childhood fatalities.

Learning Areas:
Other professions or practice related to public health

Learning Objectives:
1) Describe how childhood deaths are investigated in New Mexico 2) Name the most common causes of childhood deaths in New Mexico between 2000 and 2010 3) Compare trends in childhood deaths in New Mexico by age, year, race/ethnicity and cause and manner of death 4) Explain how medical examiner data can help formulate prevention strategies for preventable childhood deaths

Keywords: Mortality, Pediatrics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For the past 8 years I have been the epidemiologist at New Mexico's statewide medical examiner office. I am an Associate Professor of Pathology at the University of New Mexico Health Sciences Center. I analyze medical examiner data, and mentor students and residents in research design and statistical analysis. I have published numerous peer-reviewed articles which present the results of my research, and manage grants which depend on the analysis of medical examiner data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.