This summary synthesizes findings from a single research study, Report of maltreatment as a risk factor for injury death.

Young children under age 5 who are involved in a report of maltreatment are particularly vulnerable to extreme physical abuse and intentional fatal injuries, as well as unintentional injuries. This study examines whether there is a correlation between the presence of a nonfatal maltreatment allegation and child fatalities (both intentional and unintentional) in young children.

After controlling for sociodemographic characteristics that may be associated with child maltreatment (child sex, child race/ethnicity, presence of a child health risk, birth order, maternal age, maternal education, insurance type, and whether paternity was established on the birth certificate), this study found that a prior allegation to CPS was the strongest risk factor for injury mortality before age 5.

• Overall, children with a prior allegation of abuse or neglect were fatally injured at a rate that was more than 2.5 times that of children without a prior allegation.
  • Children with a previous maltreatment allegation died from intentional injuries at a rate over 5.9 times that of children without a previous maltreatment allegation.
  • Children with a previous maltreatment allegation died from unintentional injuries at a rate twice as high as children without a previous maltreatment allegation.
• One in five children (20%) who died of injuries had been previously reported to CPS.
  • When only intentional injury deaths were considered the rate rose to one-third (33%).
  • Over half (51.4%) of children under age five who died from a fatal injury had a prior non-fatal CPS allegation or died under circumstances suspicious enough to warrant a report on the date of their fatal injury or after the child’s death.

These findings indicate the need for more widespread public health prevention campaigns and targeted interventions for families that have been reported to CPS.