Does New York State Law Let You Kill a Baby on the Dayof Birth
Infant Homicides Within the Context of Safe Oasis Laws — United states of america, 2008–2017
Rebecca F. Wilson, PhDone; Joanne Klevens, MD, PhD1; Dionne Williams, MPS2; Likang Xu, MD2 (View author affiliations)
View suggested commendation
Summary
What is already known well-nigh this topic?
The highest risk for infant homicide is on the mean solar day of nativity. Considering of this, by 2008, all l states and Puerto Rico had enacted Safe Haven Laws to address infant abandonment and endangerment.
What is added by this report?
The babe homicide charge per unit on the day of nativity decreased from 222.2 per 100,000 person-years during 1989–1998 to 74.0 during 2008–2017 (66.7% decline) merely remains at least 5.four times higher than the rate at whatever other time in life.
What are the implications for public health practice?
Programs and policies that strengthen economic supports, provide affordable childcare, and raise and better skills for young parents might contribute to the prevention of infant homicides.
Altmetric:
Citations:
Views:
Views equals folio views plus PDF downloads
Homicide is the 13th leading cause of death among infants (i.eastward., children anile <1 year) in the United states (1). Infant homicides occurring within the first 24 hours of life (i.east., neonaticide) are primarily perpetrated by the mother, who might be of immature age, unmarried, have lower educational attainment, and is most likely associated with concealment of an unintended pregnancy and nonhospital birthing (two). After the first solar day of life, babe homicides might exist associated with other factors (e.g., child abuse and fail or caregiver frustration) (ii). A 2002 study of the historic period variation in homicide hazard in U.Southward. infants during 1989–1998 establish that the overall baby homicide charge per unit was eight.three per 100,000 person-years, and on the first day of life was 222.two per 100,000 person-years, a homicide rate at to the lowest degree 10 times greater than that for whatsoever other time of life (3). Because of this menstruum of heightened risk, past 2008 all fifty states* and Puerto Rico had enacted Safe Haven Laws. These laws allow a parent† to legally give up an infant who might otherwise be abandoned or endangered (4). CDC analyzed babe homicides in the U.s. during 2008–2017 to determine whether rates changed after nationwide implementation of Condom Haven Laws, and to examine the clan between baby homicide rates and state-specific Prophylactic Oasis age limits. During 2008–2017, the overall infant homicide rate was 7.2 per 100,000 person-years, and on the first day of life was 74.0 per 100,000 person-years, representing a 66.7% decrease from 1989–1998. However, the homicide rate on first day of life was still v.iv times higher than that for whatever other time in life. No obvious association was constitute between infant homicide rates and Condom Haven age limits. States are encouraged to evaluate the effectiveness of their Safety Haven Laws and other prevention strategies to ensure they are achieving the intended benefits of preventing infant homicides. Programs and policies that strengthen economic supports, provide affordable childcare, and heighten and meliorate skills for young parents might contribute to the prevention of infant homicides.
Since 1999, when Texas became the first state to implement Condom Haven Laws, an estimated 4,100 infants have been safely surrendered nationwide (5). Safety Haven Laws are practical differently in each state, and one notable deviation is the age limit of legal relinquishment (4). For example, eleven states and Puerto Rico limit relinquishment to infants who are aged ≤three days, whereas xix states allow relinquishment up to age i month (4). North Dakota allows relinquishment of infants anile <1 year (iv).
Data for this analysis come from the National Vital Statistics System, § which includes a linked birth and death document for >99% of infants who die in the The states. Nascency certificates provided demographic characteristics present at nascency (e.grand., mother's historic period). Expiry certificates indicated both an underlying crusade and manner of death, which the medical examiner or coroner is primarily responsible for certifying. Infant homicide was divers equally the expiry of a child earlier the first birthday, using the International Classification of Diseases, Tenth Revision (ICD-ten) underlying crusade of expiry codes X85–Y09, Y87.ane, U01, and U02.¶ Age at death was calculated every bit the difference in days betwixt the dates of nativity and expiry recorded on the death certificate; an infant killed on their appointment of birth had an age at death of 0 days. To examine the association betwixt homicide rates and state-specific Safe Haven historic period limits for legal relinquishment, baby homicides were categorized using historic period limits specified in state Safe Haven Laws as of 2016** (four). These age limits were treated as stable and applied throughout the entire study period. Data years 2008–2017 were used to coincide with national enactment and implementation of Condom Haven Laws. Homicide rates were presented every bit rates per person-years of exposure, which allowed for the calculation of homicide risk by age of baby, because infant homicides occurred at unlike times during infancy (east.g., twenty-four hour period of nativity, week one).††
During 2008–2017, the U.S. population aged <1 yr accounted for 39,984,337 person-years of exposure; days of birth accounted for 109,471 person-years (0.27%). The remainder of infancy accounted for 39,874,866 person-years. An estimated ii,851 infants were victims of homicide during 2008–2017 (Table 1). The overall babe homicide rate was vii.2 per 100,000 person-years. The homicide charge per unit of infants killed on the 24-hour interval of nascence was 74.0 per 100,000 person-years, which was 5.four times higher than the charge per unit at any other time of life (Supplementary Table, https://stacks.cdc.gov/view/cdc/93750).
The rate among males (8.0), who accounted for 57.4% of infant homicides, was slightly higher than that among females (6.two) (Table 1). Infants of non-Hispanic White (White) mothers deemed for 62.1% of homicides; yet, rates among infants of non-Hispanic Black (Black) mothers (xiv.iv), and not-Hispanic American Indian/Alaska Native (AI/AN) mothers (14.9) were more than than twice the rate among infants of White mothers (five.nine). Infants of Asian/Pacific Islander mothers had the everyman homicide rate (3.ane). In addition, although infants of mothers anile 20–29 years accounted for nearly two thirds (65.two%) of baby homicides, the rate among infants of mothers aged <20 years (18.7) was more than twice that amidst infants of mothers aged 20–29 years (9.one) and more than seven times that among infants of mothers aged ≥thirty years (2.6).
Overall, 75.0% of babe homicide victims were born to unmarried mothers; the homicide rate among these infants (thirteen.4) was approximately iv.5 times the charge per unit per 100,000 person-years amid infants born to married mothers (3.0). Nearly all babe homicide victims were built-in at a infirmary (95.8%); still, among the small per centum who were born at a residence (2.9%) or some other location (0.vii%), the homicide rates (23.7 and 66.9) were approximately 3.four and 9.6 times the rate among infants born at a hospital. Moreover, in the 2,371 cases where the mother's education level was reported (83.2% of all babe homicides), homicide rates were higher among infants of mothers with lower education levels (less than loftier schoolhouse, 12.ii; loftier schoolhouse graduation or equivalent, 10.8) than among infants whose mothers had college education levels (one.0–vii.one).
The percentage of homicides occurring each week of infancy varied (Figure). The outset peak occurred in the showtime week of life, when 3.nine% of all homicides occurred. A second peak occurred at week xi. Among the 111 infant homicides that occurred during the beginning week of life during 2008–2017, 73.0% occurred inside the starting time 24 hours of life, and approximately 2 thirds of those infants (65.4%) were born at a residence.
Nearly (92.4%) homicides occurred among infants who were too old for Rubber Oasis relinquishment at the time of their deaths; nonetheless, there was no obvious association between infant homicide rates and Condom Haven age limits (Table ii). For instance, the infant homicide rates in states that limit relinquishment to ≤7 days and ≤14 days were vii.0 and 9.iv per 100,000 person-years, respectively. Conversely, the infant homicide rate for states that limit relinquishment to ≤45 days compared with ≤60 days was x.6 and vii.3, respectively.
Discussion
In this study, the overall infant homicide charge per unit (vii.two per 100,000 person-years) represented a xiii.3% decrease from the 8.three rate reported during 1989–1998 (iii). Maternal characteristics associated with infant homicide included young age, being single, having lower educational attainment, having a nonhospital birthing, Blackness race, and AI/AN ethnicity.
Among infants, the highest risk for homicide is on the day of birth. The rate on the mean solar day of nascency in this written report (74.0 per 100,000 person-years) represented a 66.7% subtract from the rate of 222.2 during 1989–1998 (3), but the charge per unit on twenty-four hour period of birth was still at least 5.4 times higher than the charge per unit at whatsoever other time during life. Infant homicides occurring on the mean solar day of birth are primarily perpetrated by young, unmarried mothers with lower education levels who do not seek prenatal care; these homicides frequently are associated with concealment of an unintended pregnancy, and giving birth at a residence (2). Later the first day of life, an infant homicide might occur within the context of immature parental historic period, caregiver frustration, maternal mental illness, removal of an unwanted child, or corruption or neglect; depending on the context, the homicide might be perpetrated by the mother (2), mother's male companion, or the biologic father of the baby (6). The presence or absence of these factors is important when assessing prophylactic and quality of the infant's home environs. Racial disparities in infant homicides might exist attributed, at least in function, to the fact that Black and AI/AN families are more than likely to experience sociodemographic disparities and poverty compared with White families (7). Circumstances of poverty (e.g., inadequate resources for childcare, housing, and food) might brand parenting difficult (7). In addition, the association between infant homicide and Safe Haven age limits did not follow a linear design of risk, suggesting that rates cannot be explained past Prophylactic Oasis age limits, but might be related to other factors (e.one thousand., maternal age or unintended pregnancy) (2). Given that most (92.iv%) homicides occurred amidst infants who were too old for Safe Haven relinquishment at the time of their deaths, states are encouraged to evaluate the effectiveness of their Safe Haven Laws and other prevention strategies to ensure they are achieving the intended benefits of preventing infant homicides.
The findings in this report are subject field to at to the lowest degree two limitations. Commencement, an infant'southward decease might exist misclassified on the decease certificate (viii) or undiscovered, leading to potential underascertainment or overascertainment of baby homicides. The lack of precise pathological markers for live births or cause of death tin can atomic number 82 to errors in coding of the manner of death (nine). 2d, homicide rates for Condom Haven age-limit categories were calculated using age limits specified in country statutes equally of December 2016. Ii changes were made to state-specific age limits; one occurred during the study menses and one after. In both instances, the age limit was raised to be more inclusive. Given that age limits did not take an obvious association with infant homicide rates, the results are expected to exist similar if these changes in age limit were deemed for.
Although infants make upward a pocket-sized percentage of homicide victims, these deaths are preventable. Programs and policies that strengthen economical supports for families, provide quality and affordable childcare, develop parenting skills (e.m., through dwelling house visiting programs), clinch safe, stable, nurturing relationships and environments for all infants (10), and increase the public'south awareness of Rubber Haven Laws might contribute to preventing babe homicides.
Respective writer: Rebecca F. Wilson, ysp2@cdc.gov.
1Division of Violence Prevention, National Center for Injury Prevention and Control, CDC; 2Division of Injury Prevention, National Center for Injury Prevention and Control, CDC.
All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.
* The District of Columbia did not enact Safe Haven Laws until 2009.
† Per the information independent in state Safe Haven Laws through December 2016, the specifics about who may legally give up an baby under Condom Haven Laws vary by country. For example, in near states, either parent of the babe may legally surrender the infant to a safe oasis. However, some states only permit the mother to surrender an infant to a safe haven, while other states allow a representative of the parent (person who has permission by the parent) to legally relinquish an infant to a safe haven. Other states specify who may legally give up an infant under Condom Haven Laws in their state-specific statutes. https://www.childwelfare.gov/pubpdfs/safehaven.pdfpdf icon external icon.
§ Source: restricted-use National Vital Statistics System, linked nascence and baby death information.
¶ ICD-10 codes U01 and U02 are codes for terrorism only used in the U.s. and are not a role of the ICD-10 underlying cause codes.
** This written report used historic period limits of legal relinquishment specified in country-specific Safe Haven Laws equally of December 2016. Whatever changes made to state-specific Safe Haven historic period limits after December 2022 are non accounted for in this report.
†† Homicide rates for infants (i.e., children aged <1 yr) are commonly reported per 1,000 live births over a specified period, but alternatively, they can be reported per person-years. In this written report, because actual time at gamble for homicide is the issue of interest, and infant homicides occurred during different times of infancy (eastward.g., twenty-four hour period of nascence, week one, calendar week two, etc.), presenting rates in person-years allows for the calculation of homicide take chances by week during infancy and by day during the showtime week of life.
References
- CDC. WISQARS: leading causes of decease reports, 1981–2018. Atlanta, GA: US Department of Health and Human Services, CDC; 2020. https://webappa.cdc.gov/sasweb/ncipc/leadcause.html
- Porter T, Gavin H. Infanticide and neonaticide: a review of 40 years of research literature on incidence and causes. Trauma Violence Corruption 2010;11:99–112. CrossRefexternal icon PubMedexternal icon
- CDC. Variation in homicide risk during infancy—U.s.a., 1989–1998. MMWR Morb Mortal Wkly Rep 2002;51:187–9. PubMedexternal icon
- United states of america Department of Health and Human Services. Child welfare information gateway: infant rubber haven laws. Washington, DC: U.s. Department of Health and Homo Services; 2017. https://world wide web.childwelfare.gov/pubpdfs/safehaven.pdfpdf icon external icon
- National Condom Haven Alliance. National statistics, 2019. Glendale, AZ: National Safe Haven Alliance; 2020. https://world wide web.nationalsafehavenalliance.org/external icon
- Fujiwara T, Hairdresser C, Schaechter J, Hemenway D. Characteristics of infant homicides: findings from a U.Due south. multisite reporting organisation. Pediatrics 2009;124:e210–vii. CrossRefexternal icon PubMedexternal icon
- Quango on Community Pediatrics. Poverty and child wellness in the United states. Pediatrics 2016;137:e20160339. CrossRefexternal icon PubMedexternal icon
- Crume TL, DiGuiseppi C, Byers T, Sirotnak AP, Garrett CJ. Underascertainment of kid maltreatment fatalities by death certificates, 1990–1998. Pediatrics 2002;110:e18. CrossRefexternal icon PubMedexternal icon
- Byard RW. Medicolegal problems with neonaticide. In: Tsokos M, ed. Forensic pathology reviews, vol. i. Totowa, NJ: Humana Press; 2004.
- Fortson BL, Klevens J, Merrick MT, Gilbert LK, Alexander SP. Preventing child abuse and fail: a technical package for policy, norm, and programmatic activities. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://www.cdc.gov/violenceprevention/pdf/can-prevention-technical-parcel.pdfpdf icon
| Characteristic | No. (%) of homicides† | Rate§ (95% CI) | p-value |
|---|---|---|---|
| Age of babe | |||
| All anile <1 twelvemonth** | 2,851 | 7.2 (6.9-7.iv) | North/A |
| Commencement day of life | 81 (2.8) | 74.0 (58.8-92.0) | N/A |
| Sexual practice of infant | |||
| Male | i,636 (57.iv) | 8.0 (7.6-8.four) | <0.001 |
| Female | 1,215 (42.vi) | 6.2 (5.9-6.6) | Referent |
| Mother's historic period group (yrs) | |||
| <20 | 565 (19.viii) | xviii.7 (17.1-20.two) | <0.001 |
| 20–29 | 1,860 (65.two) | 9.one (8.seven-9.5) | <0.001 |
| ≥30 | 426 (14.9) | 2.6 (ii.iii-2.8) | Referent |
| Mother'southward race/ethnicity †† | |||
| White, non-Hispanic | 1,771 (62.1) | 5.ix (v.vi-six.one) | Referent |
| Black, non-Hispanic | 929 (32.half-dozen) | fourteen.4 (13.5-15.4) | <0.001 |
| AI/AN, non-Hispanic | 68 (two.4) | fourteen.9 (eleven.6-eighteen.ix) | <0.001 |
| Asian/Pacific Islander, not-Hispanic | 83 (2.9) | three.1 (2.4-iii.8) | <0.001 |
| Mother'south marital status | |||
| Married | 705 (24.7) | iii.0 (two.8-3.2) | Referent |
| Unmarried | ii,137 (75.0) | 13.4 (12.8-14.0) | <0.001 |
| Unknown | 9 (0.3) | — | — |
| Mother's highest educational level | |||
| Less than HS | 698 (24.5) | 12.2 (11.3-13.1) | Referent |
| HS or GED document | 939 (32.9) | 10.8 (10.1-11.5) | 0.016 |
| Some college, no degree | 504 (17.7) | 7.i (6.v-seven.7) | <0.001 |
| Associate or bachelors' degree | 193 (half dozen.8) | 2.1 (1.viii-2.4) | <0.001 |
| Graduate degree | 37 (one.three) | one.0 (0.7-1.4) | <0.001 |
| Unknown | 480 (16.viii) | — | |
| Baby'south place of birth | |||
| Hospital | 2,730 (95.8) | 7.0 (vi.7-7.two) | Referent |
| Freestanding nascency center | 5 (0.2) | — | — |
| Residence | 82 (ii.9) | 23.vii (18.nine-29.v) | <0.001 |
| Other location | 20 (0.seven) | 66.ix (forty.nine-103.iii) | <0.001 |
| Unknown | fourteen (0.v) | — | — |
Abbreviations: AI/AN = American Indian/Alaska Native; CI = confidence interval; GED = General Education Evolution; HS = loftier school; N/A = not applicable.
* During 2008–2017, approximately 2,919 infants were victims of homicide (https://webappa.cdc.gov/sasweb/ncipc/mortrate.html). Because this study used restricted-utilize National Vital Statistics System linked birth and infant death data, 68 infant homicides were excluded considering the corresponding nascence and death certificates could not be linked.
† Percentages might not sum to 100% because of rounding.
§ Number of deaths per 100,000 person-years. Rates are not reported for subgroups in which the number of babe homicides is <20 or response is unknown.
¶ Infant homicides for Puerto Rico were not available for this assay.
** Includes infants who died on first day of life.
†† Mother's race/ethnicity is the all-time measure of race/ethnicity of the baby; thus, babe race/ethnicity is based on mother's race/ethnicity as reported on the infant's birth certificate.
FIGURE. Pct of infant homicides, by age at expiry (weeks) — restricted-utilize National Vital Statistics System, linked nativity and infant death data, United States, 2008–2017
| State/Surface area where homicide occurred | Safe Oasis Law age limit | No. (%) of homicides† | Rate per 100,000 person-years (95% CI)§ |
|---|---|---|---|
| Alabama, Arizona, California, Colorado, Hawaii, Michigan, Mississippi, Tennessee, Utah, Washington, Wisconsin | 3 days | 738 (25.ix) | 6.iii (5.8–six.7) |
| Florida, Georgia, Massachusetts, Minnesota, New Hampshire, North Carolina, Oklahoma | 7 days | 478 (16.8) | 7.0 (6.4–vii.6) |
| Maryland | 10 days | 54 (i.9) | vii.seven (five.seven–x.0) |
| Delaware, District of Columbia, Iowa, Virginia, Wyoming | 14 days | 162 (v.7) | nine.4 (viii.0–x.9) |
| Alaska | 21 days | — | — |
| Arkansas, Connecticut, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maine, Montana, Nebraska, Nevada, New Jersey, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, W Virginia | 30 days | 923 (32.4) | vii.4 (6.ix–vii.eight) |
| Kansas, Missouri | 45 days | 124 (4.4) | 10.six (8.7–12.4) |
| Southward Carolina, Southward Dakota, Texas | lx days | 335 (11.8) | seven.3 (half dozen.5–viii.0) |
| New Mexico | 90 days | 22 (0.8) | 8.six (v.4–13.0) |
| North Dakota | <1 year | — | — |
Abbreviation: CI = confidence interval.
* During 2008–2017, approximately two,919 infants were victims of homicide https://webappa.cdc.gov/sasweb/ncipc/mortrate.html. Because this study used restricted-utilize National Vital Statistics System linked nascence and infant death data, 68 infant homicides were excluded because the corresponding birth and expiry certificates could not exist linked. The District of Columbia did not enact a Safe Haven Police until 2009; therefore, the ii babe homicides that occurred in 2008, in the District of Columbia, were removed when infant homicide rates were examined within the context of Safe Haven Laws. Counts are not reported when the number of infant homicides is <10.
† Percentages might not sum to 100% because of rounding.
§ Babe homicide rates are based on the land in which the infant's expiry occurred (i.east., state of occurrence). Rates are not reported when number of infant homicides is <20. Denominator includes number of live births multiplied by the Safe Haven days in each Safe Haven age limit category.
¶ Infant homicides for Puerto Rico, which has a Rubber Oasis Law age limit of 3 days, were not available for this analysis.
MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services.
Use of trade names and commercial sources is for identification simply and does not imply endorsement by the U.Southward. Department of Health and Human Services.
References to non-CDC sites on the Cyberspace are provided every bit a service to MMWR readers and exercise non constitute or imply endorsement of these organizations or their programs by CDC or the U.Due south. Section of Health and Human being Services. CDC is not responsible for the content of pages plant at these sites. URL addresses listed in MMWR were electric current as of the appointment of publication.
All HTML versions of MMWR articles are generated from final proofs through an automatic process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (https://world wide web.cdc.gov/mmwr) and/or the original MMWR newspaper copy for printable versions of official text, figures, and tables.
Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
Source: https://www.cdc.gov/mmwr/volumes/69/wr/mm6939a1.htm
0 Response to "Does New York State Law Let You Kill a Baby on the Dayof Birth"
Post a Comment