Doctoral Student Fellowship

Emily Putnam-Hornstein, School of Social Welfare

Do "accidents" happen? An examination of injury mortality among maltreated children

Graduated School of Social Welfare Doctoral Program in 2010

Currently serves as an Assistant Professor of Social Work, USC



A common analogy used to describe the phenomenon of child abuse and neglect is that of an "iceberg". Those maltreated children who are referred to child protective services (CPS) represent the tip that emerges above the water, while a much larger population of maltreated children remain below the surface. The true size of the iceberg – the population of children harmed, or at risk of harm - is unknown. Also unknown is the extent to which children referred to CPS can be considered a representative or biased sample of all maltreated children. Since data collected by CPS is (by its very nature) incomplete, and the outcomes it tracks limited, the surveillance of child abuse and neglect, as well as the assessment of CPS decision-making and evaluation of child protection service interventions, require the use of other sources of data. This dissertation seeks to use injury mortality data as a population-based indicator of the latent risk faced by children who are referred for possible violence at the hands of their parents. Of interest is whether children who are referred for abuse or neglect face a heightened risk of injury mortality (both intentional and unintentional) than do non-referred, but sociodemographically similar children. This dissertation project involves the linkage of administrative child protective service records available from California's Department of Social Services (CDSS) to population-wide vital birth and death records from California's Department of Public Health (CDPH). Using probabilistic linkage software, individual children will be matched across these three data sources based on a combination of unique and non-unique personal identifiers. The resulting analysis will reflect the full population of children born in California between 1999 and 2006 (~4 million births) and include all CPS contacts and deaths occurring before the age of five. The creation of this unique dataset – and the resulting dissertation – will generate new knowledge concerning violence against children, with practical implications relating to the identification of abuse and neglect victims, the targeting of services, and the prevention of adult-perpetrated violence against young children.


Related Publications:

1. Putnam-Hornstein, E. (2012). Preventable injury deaths: a population-based proxy of child maltreatment risk. Public Health Reports, 127(2), 163-172.

2. Putnam-Hornstein, E. (2011). Report of maltreatment as a risk factor for injury death: a prospective birth cohort study. Child Maltreatment, 16(3), 163-174.

3. Putnam-Hornstein, E., Webster, D., Needell, B. & Magruder, J. (2011). A public health approach to child maltreatment surveillance. Child Abuse Review, 20, 256-273.

4. Putnam-Hornstein, E. & Needell, B. (2011). Predictors of child welfare contact between birth and age five: an examination of California’s 2002 birth cohort. Children & Youth Services Review, 33 (11), 2400-2407.