An annual report on Arizona child fatalities for the first time identifies children who died because they were not properly supervised or cared for, including 23 children whose deaths were attributed to neglect.
Overall, 36 children died from abuse or neglect last year, according to the Arizona Child Fatality Review Team’s 10th annual report. They are among 935 child deaths in 2002, 30 percent of which were deemed preventable by medical, police, child abuse and other experts who make up the team.
The report comes as the Legislature is debating reforms to the state’s child welfare system.
"We felt like we were missing a lot of the child maltreatment deaths," said Dr. Mary Ellen Rimsza, director of student health at Arizona State University and chairwoman of the fatality review team. "And I think it’s important, because of what’s going on at the Legislature, for them to understand what the real numbers are."
In the past, the child fatality report listed only child abuse deaths, including children who had been shaken or intentionally killed. Now, a separate category of "child maltreatment" captures those who died because of neglect or abuse. Their deaths also may be listed in other categories, including homicide, drowning or medical conditions.
Examples include medical neglect cases, where infants died of pneumonia, malnutrition or other ailments that could have been diagnosed and treated. A teenage suicide victim whose family failed to seek mental health care for their child but knew the teen was depressed and suicidal also is included.
"I think it’s an important reminder that we’re not just talking about numbers on a page," said Dana Naimark, deputy director of the Children’s Action Alliance. "We are literally talking about life and death of kids in our communities."
Nearly half of the children who died as a result of abuse or neglect had Child Protective Services reports.
Of those 14 children, the number of CPS reports ranged from one to nine. Most of the children were 4 years old or younger.
CPS may have investigated the family for something unrelated to what led to a child’s death, said David Berns, director of the state Department of Economic Security, which oversees CPS. The ages of the children also may prevent families from coming to the attention of CPS, he said.
"We don’t have the eyes of the schools and we don’t have the ability for kids to come forward and make complaints to anybody else," Berns said of younger children. "We all have to be watchful and mindful."
Berns said his agency needs additional funding so workers can spend more time with families, better assess their needs and ensure they are receiving needed services.
A current special session of the Legislature so far has balked at providing the $35.5 million that Gov. Janet Napolitano has requested to cover a shortfall in CPS, hire more caseworkers, increase their salaries, and strengthen adoption and foster care programs.
Half of the children who died of abuse or neglect lived in families with a history of drug or alcohol abuse.
State Sen. Mark Anderson, R-Mesa, is pushing an amendment to CPS legislation that would create a treatment program for mothers who risk losing their children to foster care.
Among the 23 neglect deaths, 11 were from drowning, fires, suffocation or car crashes, and nine were classified as medical neglect.
The 11 child abuse deaths marked an increase from nine deaths in 2001.
Other findings in the report include:
• Of the 277 deaths deemed preventable, 37 percent were linked to lack of supervision. Drowning deaths were down from 40 in 2001 to 31 in 2002, but 25 of last year’s deaths could have been prevented if the child had been more closely supervised.
• Suicides were down slightly, from 28 deaths in 2001 to 24 deaths last year. Fifteen of the children were in the midst of some kind of crisis and six of the children had told others they were thinking of suicide. Ten of the victims were between 10 and 14 years old.
• Only 19 of the 109 children who died in vehicle crashes were properly belted in, and 15 of the children who died were pedestrians.
• The deaths of 46 children were ruled homicides, including eight infants. Sixty percent of the homicide deaths were Hispanic children.
• Eight children died of exposure, including seven who were crossing the desert to enter the United States illegally.
The review team made several recommendations to prevent child deaths, including a statewide requirement for pool fencing, expanded child abuse prevention programs and additional funding for CPS, a sudden infant death syndrome public awareness campaign, removing guns from the homes of suicidal children and providing health insurance for all Arizona children.
"It’s very costly to have a reactive system like we have instead of the proactive system that we need," said Dr. Kathryn Coffman, a pediatrician with Childhelp Children’s Center in Phoenix. "And the human costs are terrible."
• For more information or to obtain a copy of the report, call the Arizona Child Fatality Review Program, (602) 542-1875 or visit