The Kansas State Child Death Review Board (SCDRB) has issued its 2024 Annual Report. The report examines the circumstances surrounding the deaths of all Kansans aged birth to 17 years old, as well as non-resident children, who died in Kansas in 2022. The inclusion of all 2022 child fatalities, as well as use of data from the previous four years to allow for more granular analyses, make this report exemplary compared to many other state child death reports. It is important to note that this is not a report on child maltreatment fatalities and it does not identify the fatalities that are due to maltreatment, except among the homicides. But there are still several important takeaways related to child abuse and neglect deaths.
- Consistent with prior research, a history of child protection system involvement is common among children who die. Of the 1,463 children who died of any cause between 2019 and 2022, 529 (or 36 percent) had some history with the child protection system (CPS). When natural deaths are excluded (leaving deaths from unintentional injuries, homicide, suicide and undetermined reasons), the percentage of fatalities with CPS involvement increased to 52 percent. Among child homicide victims, past CPS involvement was observed for 71 percent. This is not surprising in light of the research on the connection between child maltreatment and crime. The board suggested that practice errors (e.g., flawed investigations, erroneous case closures) contributed to many of these fatalities, but the analysis was limited.
- Sixty-eight percent of child maltreatment homicide victims had suffered prior abuse, investigations revealed: There were a total of 35 child abuse homicides (a category defined as homicides due to abuse or neglect) between 2018 and 2022, or 29 percent of all homicides. The board found that 74 percent of the victims were aged four or under; 34 percent had not reached their first birthday. Most of these homicides (68 percent) involved blunt force trauma. The suspected perpetrator was the biological parent in 63 percent of these deaths; in 23 percent of these cases the mother’s boyfriend or ex-boyfriend was the suspected perpetrator. The board concluded that “[f]rustrated caregivers, often with minimal parenting training[,] have unrealistic expectations for children’s behavior with a lack of appreciation for their vulnerability.”
- Drug related child deaths are increasing. The Board documented a significant increase in drug-related child deaths since 2020, mostly related to fentanyl. There were 33 fentanyl deaths between 2020 and 2023, compared to no such deaths in 2018 and 2019. The Board indicated its increasing concern about the number of younger children who die from ingestions. Ten children under age five died of drug ingestion between 2018 and 2022, and five of those cases involved fentanyl. Not discussed in the report is the extent to which substance abuse by parents contributed to other types of fatalities, such as those attributed to unsafe sleep.
- Large racial disparities existed in all manners of death. The report documents large racial and ethnic differences in the rate of natural deaths, unintentional injury deaths, homicide deaths, suicide deaths and deaths for which the manner was undetermined, with the highest death rates for Black children and youth. The starkest contrast was in the homicide death rate, which was 17.4 per 1000 for Black children and youth versus 5.4 and 1.4 for Hispanic and White children and youth, respectively.
The Board made several proposals for improving investigations, including revamped training for caseworkers focusing on legislative mandates that are not always being followed. But the Board also recognized that implementing these recommendations requires manageable caseloads and adequate funding for hiring qualified investigators. The report recommended improved maltreatment reporting, but did not address the screening of reports, which is often an area where deficiencies are observed. Additional proposals included timely referrals for drug and alcohol assessments and treatment when parental use is suspected, consistent and regular monitoring of cases, and effective and frequent communication with other community agencies providing services to families known to CPS. These are, of course, also dependent on funding and staffing.
The Board also made a series of recommendations to improve the quality of law enforcement investigations and prosecutions of child deaths and near fatalities. Early in the report there is a statement that “The DCF policy of allowing newborns and infants to remain in a home previously deemed unsafe for older children to be successfully reintegrated into, needs to be reconsidered.” Unfortunately, this proposal did not make it to the list of recommendations at the end of the report; perhaps it was considered futile in a climate where child safety is at best a secondary concern.