Teri Covington "Child Death Review Teams" Part 1 NDPA 2012

What Child Death Review Teams Can Tell Us about Drowning

Maximizing the Opportunities to Prevent Infant and Child Drownings

Teri Covington, MPH,

Sharing the Story

Guiding Principles

A Comprehensive Purpose

Investigation/Response Services Prevention

CDR in the U.S.

Healthy People 2020

At a Review Meeting

No supervision Poverty

Poor supervision

Poor Access

to EMS care

Unable to read

No fencing

Impulsive behavior

Stress Teenagers

Substance Use

Boys

No zoning ordinances

Poor signage

Drowning

Faulty gates

Bad weather

Unable to swim

No child care

Identify the Risk Factors

Green water

CDR Case Reporting System

System Features

Limitations of the Data

Data on Drowning

MT

WY

ID

WA

OR

NV

UT CA 10%

AZ 7%

ND

SD

NE

CO

NM

TX 17%

OK

KS

AR

LA

MO

IA

MN

WI

IL IN

KY

TN 6%

MS AL GA

FL

SC

NC

VA WV

OH 9%

MI 7%

NY

PA 5%

MD

DE

NJ CT

RI

MA

ME

VT

NH

HI

No drownings in the database

With other 6 states, represents more than 60% of the cases

Included in data

States with Data in the System n=2,440, 1996-2011, 92% from 2005-2011

No supervision Poverty

Poor supervision

Poor Access

to EMS care

Unable to read

No fencing

Impulsive behavior

Stress Teenagers

Substance Use

Boys

No zoning ordinances

Poor signage

Drowning

Faulty gates

Bad weather

Unable to swim

No child care

Identify the Risk Factors

Green water

AGE and Gender, by Percent n=2,440

Under age 1

8%

Ages 1 - 4 48%

Ages 5 - 9 14%

Ages 10-14 12%

Ages 15 - 18 16%

Over 18 Years Old

1% UK 1%

By Age

Male 68%

Female 31%

UK 1%

By Gender

Data Source: NCRPCD Case

Race and Ethnicity, by Percent n=2,440

White 66%

African American

19%

Native Hawaiian

1%

Pacific Island

0% Asian

3%

Amer Indian

1%

Multi-racial 1%

UK 9%

By Race n=2440

Yes 20%

No 71%

UK 9%

By Hispanic Origin

Data Source: NCRPCD Case

By Location and Child’s Activity n=2,440

Open water 30%

Pool/hot tub 43%

Bath tub 14%

Other 8% UK

5%

Playing 33%

Swimming

15%

Bathing 10% Sleeping

2%

Other 18%

UK 22%

Child's Activity Last Seen Before Drowning Place of Drowning

Location of Drowning by Age

Place

Under age 1

Ages 1 - 4 Ages 5 - 9 Ages 10-14

Ages 15 - 18

Over 18 Years Old

Missing Total

Open water

Count 3 175 116 167 262 16 1 740

% 1% 15% 35% 55% 68% 73% 7% 30%

Pool, hot tub, spa

Count 17 734 146 81 61 2 4 1045

% 8% 62% 44% 27% 16% 9% 27% 43%

Bath tub Count 148 130 33 17 16 3 0 347

% 72% 11% 10% 6% 4% 14% 0% 14%

Other Count 28 88 23 28 24 1 1 193

% 14% 7% 7% 9% 6% 5% 7% 8%

UK Count 9 50 13 11 23 0 9 115

% 4% 4% 4% 4% 6% 0% 60% 5%

Total Count 205 1177 331 304 386 22 15 2440

% 100% 100% 100% 100% 100% 100% 100% 100%

33 kids died in bathtub btn ages 5-9 (5 were homicides; 23 accidents; 5 undetermined) (15 of 17 kids ages 10-14 died in bathtub were accidents.) (13 of 16 of kids ages 15-18 died in bathtub were accidents)

Pool Drownings

Above ground 20%

In ground 60%

Wading 2%

Hot tub/spa 3%

UK 15%

Type of Pool n=1045

Private 63%

Public 9%

UK 28%

Type of Pool Ownership n=1045

In two percent of the pool drownings (n=21), child found on top of or under a pool cover

In 52% of public pool drownings (n=96), no lifeguard was present.