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

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.