Causes and Effects of Child Abuse - Household Composition And Risk Of Maltreatment Death

In 2002 an estimated 1,390 children died of abuse or neglect in the United States. About 76% of these children were younger than four, making maltreatment the main cause of injury death in this age group. Another 12% of victims were ages four to seven. To determine the role of family composition as a risk factor for fatal child maltreatment, researchers examined all information related to Missouri resident children under five years old who died in that state within a three-year period (Michael N. Stiff-man, Patricia G. Schnitzer, Patricia Adam, Robin L. Kruse, and Bernard G. Ewigman, "Household Composition and Risk of Fatal Child Maltreatment," Pediatrics, vol. 109, no. 4, April 2002).

Stiffman et al. used the comprehensive data of child deaths (birth through age seventeen) collected by the Missouri Child Fatality Review Panel (CFRP) system between 1992 and 1994. The CFRP data contained information on all household members and their relationship to the deceased child. For comparison, the researchers used a control group consisting of children under age five who had died of natural causes. Of the 291 injury deaths that were examined, 60% (175 children) were determined to have died of maltreatment. Nearly one-third (31%, or fifty-five children) of the deaths resulted from injury caused by a parent or other caregiver. Of this group, thirty-nine of the children died from being shaken, hit, or dropped. Eleven children died from the use of physical objects, including guns. The cause of death for the remaining five children was unknown.

The study found that children living in households with one or more biologically unrelated adult males and boyfriends of the child's mother had the highest risk of death from maltreatment. These children were eight times more likely to die of maltreatment than children living with two biological parents with no other adults. Children residing with foster and adoptive parents, as well as with stepparents, were nearly five times as likely to suffer maltreatment deaths. Those living in households with other adult relatives present were twice as likely to die from maltreatment. Children living with just one biological parent, however, with no other adult present, were not at increased risk for fatal maltreatment.