A Jumble of Standards: How State and Federal Authorities Have Underestimated Child Maltreatment Fatalities

Key Points

Each year, states are required to submit data to the National Child Abuse and Neglect Data System. However, because of restrictive definitions, failure to consult all available sources, or the decision not to investigate certain maltreatment-related deaths, states’ reports greatly underestimate the number of child fatalities due to maltreatment.
Though the official numbers appear to show that child fatalities are increasing each year, year-to-year changes in fatality numbers should be approached with caution.
A state’s child maltreatment fatality number reflects the way the state defines and determines child maltreatment fatalities.

“There is no standard, mandated reporting system for child abuse or neglect deaths in this country. Definitions, investigative procedures, and reporting requirements vary from state to state. Attributing a child’s death to abuse rather than to an accident or natural cause is often extremely difficult. The death of a toddler who drowns in a bathtub, for example, may be classified as an accident in one jurisdiction or as a child neglect death in another.”

—Committee to Eliminate Child Abuse and Neglect Fatalities, Within Our Reach, 2016¹

The annual child maltreatment reports produced by the Children’s Bureau of the US Administration for Children and Families are based on data that states submit to the National Child Abuse and Neglect Data System (NCANDS).² These reports are eagerly anticipated in the child welfare policy community because they provide much of the data commonly used to quantify child maltreatment and the operations of Child Protective Services (CPS) agencies around the country. The latest report, Child Maltreatment 2022 (CM2022),³ provides data for federal fiscal year (FFY) 2022, which ended on September 30, 2022.

This report discusses the findings in CM2022 on child maltreatment fatalities specifically. (A more general discussion of CM2022 is provided on my blog, Child Welfare Monitor.)⁴ It explores the extent to which states’ child maltreatment fatality rates reflect how they define and determine fatalities. This diversity makes it difficult to evaluate the total number of fatalities reported, differences between state maltreatment fatality rates, and differences over time. More specifically, several key points emerge from the analysis.

First, states reported approximately 1,990 child fatalities to the federal government for FFY2022. Yet it is widely recognized that states’ reports to the federal government greatly underestimate the number of child fatalities due to maltreatment. States may use restrictive definitions, fail to consult all available sources, or decide not to investigate or substantiate some maltreatment-related deaths. The states’ commentaries in CM2022 reveal great diversity in how they determine child maltreatment fatalities. In states where child death review (CDR) teams estimate the number of maltreatment deaths, their estimates are always higher than the NCANDS estimates, with some CDR estimates as much as two, three, or even 10 times higher.

Second, CM2022 shows child fatalities increasing every year between FFY2018 and FFY2022. But year-to-year changes should be approached with caution. Most states report for each fiscal year the number of maltreatment fatalities identified during that year, not the number that occurred during that year. However, at least two states, including the state with the largest number of children (California), report fatalities based on the year of occurrence and report additional deaths in subsequent years as they are identified. For this reason, even five-year trends shown in CM2022 may change over time.

Adjusting for the changes in reports for these two states, it appears that child maltreatment fatalities have indeed been increasing since 2013. But several states report improvements in their ability to capture child maltreatment fatalities for NCANDS reporting. Thus, we do not know the extent to which this increase reflects improved reporting as opposed to increasing deaths from abuse or neglect.

Third, the data reported in CM2022 show that child maltreatment fatalities are concentrated in the youngest children and become less frequent as age increases. Boys are somewhat more likely than girls to die of maltreatment. Black children are much more likely than white or Hispanic children to die of maltreatment—two to three times as likely as white children, depending on the year. The broad category of “neglect,” defined as “neglect or deprivation of necessities,” was involved in 76 percent of child maltreatment fatalities, while abuse was involved in 42 percent. Another 8.3 percent of child maltreatment fatalities involved medical neglect.

Read the full report.

Notes

Commission to Eliminate Child Abuse and Neglect Fatalities, Within Our Reach: A National Strategy to Eliminate Child Abuse and Neglect Fatalities, 2016, 23–24, https://www.acf.hhs.gov/sites/default/files/documents/cb/cecanf_final_report.pdf.
US Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, “Child Maltreatment,” June 27, 2023, https://www.acf.hhs.gov/cb/data-research/child-maltreatment.
US Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, Child Maltreatment 2022, January 29, 2024, https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2022.pdf. Except when a reference is provided, information in this report is drawn from Child Maltreatment 2022.
4. Marie Cohen, “Child Maltreatment 2022 Reports Increase but Response Lags,” Child Welfare Monitor, February 6, 2024, http://childwelfaremonitor.org/2024/02/06/child-maltreatment-2022-reports-increase-but-response-lags.