A state committee focused on child abuse and neglect spent about a year analyzing child deaths resulting from abuse or neglect.
The Child Fatality Review Panel Subcommittee on Child Abuse and Neglect Fatalities recently released its findings - Eliminating Child Abuse and Neglect Fatalities in Missouri, which looked at data from 2015.
Published in late April, the report looked at 58 infant deaths from across the state and attributed about 32 percent of the deaths to unsafe sleep environments.
Sleep-related deaths remain a leading cause of death for Missouri infants, the report determined. It's 2019 predecessor looked at data from 2014 and came to the same conclusion.
Safe sleep has been a priority in preventing children's deaths.
Missouri has championed safer sleeping environments for children for years.
The state's Safe Cribs for Missouri program provides free portable cribs and safe sleep education for mothers who qualify - low-income families that have no other resources for obtaining a crib. Clients must be eligible for the Women, Infants and Children program or have an income at or below 185 percent of the federal poverty level.
Jill Prater, a registered nurse and family planning coordinator for the Cole County Health Department, said the county has been successful in getting cribs into the hands of mothers who need them.
Over the past two years, it has distributed 23 cribs to clients, Prater said.
"Once the state of Missouri approves a client for a crib, the crib is shipped to the Cole County Health Department. And then, the client is called to come pick up the crib and attend an educational session regarding safe sleep for their baby," Prater said.
The continuing number of preventable deaths from unsafe sleep environments is troubling, Jennifer Tidball, acting director of the Missouri Department of Social Services, said in a news release.
The 2021 executive report may be found at www.dss.mo.gov/re/pdf/cfrar/2021-eliminating-child-abuse-and-neglect.pdf.
The study was intended to "identify effective prevention and intervention processes to decrease preventable child deaths through systematic evaluation of individual child deaths and the personal, familial, and community conditions, policies, and behaviors that contribute to preventable deaths," the report states.
Its goal is to advocate for actions to prevent child deaths, and to keep children healthy, safe and protected.
In 2012, then-President Barack Obama signed the Protect Our Kids Act, which established a commission to eliminate child abuse- and neglect-related deaths. The commission recommended: steps regarding use of federally funded child welfare services; best practices for prevention of abuse and neglect fatalities; federal, state and local data collection systems and their improvement; mitigation of risk factors; and prioritization of prevention services for families.
The commission also recommended each state review the previous five years of child abuse- and neglect-related deaths, which led to creation of the subcommittee.
Missouri statute has required each county to create a child fatality review panel since 2014. County prosecuting attorneys are tasked with organization of the panels, which investigate the deaths of children younger than 18. Panels include the prosecuting attorney or circuit attorney, coroner or medical examiner, law enforcement personnel, member of the children's division, public health care specialist, representative from juvenile court and emergency medical provider. Other participants may be included.
The subcommittee intended to improve accuracy of identification and classification of abuse- and neglect-related fatalities; identify risk factors; assess system factors and how they functioned at times surrounding deaths; and develop prevention strategies, according to the report.
It acknowledged "neglect" is a broad spectrum, so it took a wide-ranging look at the issue to focus on children and their environments, and avoided casting blame.
That resulted in public awareness campaigns, child protective services including more education during home visits, and distribution of free devices that make homes safer and more secure.
"For most families, there is not one thing that leads to a child dying due to abuse and neglect; rather, there is a combination of risk factors that together create the perfect storm and an environment that is dangerous for a child," the report states. "Families face a variety of social issues, including parental substance abuse, mental health problems, intimate partner violence, extreme poverty, multi-generational abuse and neglect."
The involved families regularly have multiple touches with different agencies that have opportunities to intervene. But, interventions are also often made difficult by lack of family cooperation, frequent moves and inconsistent inter-agency communication.