Data Analytics, Prevention Efforts Could Drive Down Child Deaths

By Beth Cortez-Neavel

Texas is taking serious steps toward using predictive data analytics, or “big data,” to prevent child deaths due to abuse and neglect.

Not only are state officials finally catching on that child maltreatment is a public health issue, there are three new state-led efforts to curtail child deaths and maltreatment by using data to pinpoint specific warning signs at different community levels.

Texas is following in the footsteps of California, which has already begun to use big data to reform child welfare and is slowly integrating groundbreaking research that links childhood trauma and negative experiences to a greater likelihood of adult social and health problems.

Two state agencies, the Department of Family and Protective Services and the Department of State Health Services, teamed up last April to analyze three years’ data from each department. In early March, the departments released a report of their findings and indicated they have plans in the works to target prevention, intervention and education programs in the state’s most needed areas.

The report, named the “Strategic Plan to Reduce Child Abuse and Neglect Fatalities,” compared child abuse fatality data with public health information between 2010 and 2012. Researchers looked at birth and death certificates and matched those to other factors like parental income, benefits, level of parental education, crime, and health.

“This report … is a milestone for child abuse prevention in Texas,” said Sasha Rasco, director of prevention and early intervention for the Department of Family and Protective Services, in a department press release. “Building upon past research connecting adverse childhood experiences to health outcomes in adults, we finally can see child abuse as a public health issue, and a community problem that can only be attacked with community solutions.”

The data showed that between 2010 and 2012, a documented 686 children died of abuse and neglect in Texas. The press release states there were “unusually high numbers” of recorded sleep-related deaths and deaths of children in hot cars. There was also a prevalence of child deaths due to physical abuse. The data showed two-thirds of mothers whose children died of abuse or neglect received Women, Infants and Children (WIC) benefits while pregnant and that infants who died from sleep-related neglect were likely to have a mother who smoked during pregnancy. The report outlined public education efforts surrounding hot car deaths, a pilot program to train employees of clinics with a high prevalence of clients receiving WIC benefits on safe sleep practices, and coordination with local agencies to develop better ways to screen for domestic violence.

The study also found that 47 percent of recorded child fatalities in Texas had prior involvement with Child Protective Services, the branch of the Department of Family and Protective Services that investigates reports of child abuse and neglect. This means the state was either in the process of investigating these cases for child abuse and neglect, had determined the child was being abused or neglected or had closed the case without identifying abuse or neglect.

“We must use a laser-focused analysis on all factors related to those deaths in order to determine future targeted child abuse prevention and family strengthening resources,” said Madeline McClure, CEO of Dallas-based child welfare non-profit TexProtects. “These child deaths … could inform our staffing levels, investigation procedures, removal and reunification decisions, effectiveness of services to these families and how or where to target evidence-based prevention program efforts.”

TexProtects champions stemming child maltreatment through the lens of research on adverse childhood experiences (ACEs) by approaching families holistically. ACEs research shows domestic violence, drug addiction, or other unhealthy behaviors in a child’s home environment often lead to behavioral problems, shorter lifespans, substance abuse, mental illnesses, physical ailments and increased stress and anger as an adult.

“We have been beating the drum on this since 2006,” McClure said.

Tuesday afternoon, the Texas Office of Child Safety released a related study on child fatalities. The state legislature and the Department of Family and Protective Services have vowed to reform the child welfare system after an increase of deaths of children under state care in 2013 and 2014.

The Department of Family and Protective Services Commissioner John Specia formed the office in September 2014 to independently analyze child abuse and neglect fatalities, near fatalities and serious injuries. There were a reported 156 child deaths, with 11 being children within the foster care system, due to abuse and neglect in Texas in the 2013 fiscal year, a 26 percent decrease from the 212 deaths in FY 2012.

To further data collection efforts, State Sen. Carlos Uresti (D-San Antonio) has also filed a bill this legislative session to improve child fatality reporting and the release of information to the public. The bill would also require the Department of Family and Protective Services to produce an annual report on child fatality investigations. As of April, the bill passed unanimously in the Senate and has moved on to the Texas House of Representatives.

Twenty years ago, Kaiser-Permanente, a California-based healthcare system, paired with the Centers for Disease Control and Prevention to retroactively look at the adverse childhood experiences (ACEs), or childhood trauma, of 18,000 adults. As mentioned above, the data linked traumatic childhood experiences and unhealthy or dangerous home environments to an increased likelihood of adult health problems.

A 2011 study led by Emily Putnam-Hornstein at the University of California, Berkeley, used public health data and data from the child welfare system to look at four years of child maltreatment for trends.

Putnam-Hornstein’s team found that between 1999 and 2002, children with certain profile markers had a higher risk of being reported to the child welfare system for suspected abuse or neglect. The list includes children born without fathers listed on their birth certificates, teen mothers, mothers who had not completed high school and mothers on public health insurance.

In 2013, Putnam-Hornstein released a similar study. This one tracked children of young mothers who were known to the Los Angeles child protection system. The study found that by age five, 18 percent of children whose mothers had been confirmed victims of abuse or neglect also were reported as victims.  The Texas departments said they intend to continue studying ACEs in child populations in the future.

Beth Cortez-Neavel is a freelance journalist based in Austin, Texas.  She reports on child welfare and child and adolescent mental health.  Find her on Twitter @ecortez_neavel. 

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