Advertisement

Canadian Journal of Public Health

, Volume 105, Issue 2, pp e103–e108 | Cite as

Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010)

  • Jayantha C. Herath
  • Saman Kalikias
  • Susan M. Phillips
  • Marc R. Del BigioEmail author
Quantitative Research

Abstract

OBJECTIVE: The goals of analyzing all non-natural childhood deaths in Manitoba for the 22-year period (1989–2010) are to highlight preventable causes of death and to document temporal trends that might be influenced by changes in society.

METHODS: The 1989 to 2010 pediatric autopsy database at the Winnipeg Health Sciences Centre and records from the Office of the Chief Medical Examiner were searched for all non-natural deaths ≤ 18 years age. All files were reviewed in detail. Data collected included demographic characteristics, manner of death, details of cause and circumstances leading to death, and survival time after the event.

RESULTS: For the 22-year period, the total number of non-natural childhood deaths after which autopsy was performed in Manitoba was 581 for males and 409 for females in a population of approximately 1.23 million (2010 estimate). This represents 22.1 % of the total childhood deaths in Manitoba during the study period. A higher proportion of children living in rural and northern communities died from non-natural causes. Of all accidents, which peaked in 1999, road traffic incidents accounted for the majority. Of suicides, which peaked in 2005, hanging in the 15-18 year group accounted for almost all cases. Of homicides, child abuse deaths at <3 years age was the most frequent cause. For all causes, most individuals were dead at the scene or died shortly thereafter.

CONCLUSIONS: Most non-natural childhood deaths in Manitoba might be avoidable through education about prevention strategies and by correction of social inequities. Improved transportation to hospital from remote locations would likely have little impact on survival.

Keywords

Epidemiology trauma death adolescent hanging accidental 

Résumé

OBJECTIF: Notre analyse de tous les décès d’enfants de causes non naturelles au Manitoba sur une période de 22 ans (1989–2010) vise à faire ressortir les causes de décès évitables et à décrire les tendances temporelles qui pourraient être influencées par les changements sociétaux.

MÉTHODE: Nous avons interrogé la base de données des autopsies pédiatriques de 1989 à 2010 du Centre des sciences de la santé de Winnipeg et les dossiers du Bureau du médecin légiste en chef pour obtenir tous les décès de causes non naturelles d’enfants de ≤ 18 ans. Les dossiers ont été examinés en détail. Les données recueillies incluaient le profil démographique, le mode de décès, les causes et les circonstances ayant conduit au décès, ainsi que la durée de survie après l’événement.

RÉSULTATS: Sur la période d’étude de 22 ans, le nombre total de décès d’enfants de causes non naturelles suivis d’une autopsie au Manitoba était de 581 pour les garçons et de 409 pour les filles pour une population d’environ 1,23 million d’habitants (estimation de 2010). Ceci représente 22,1 % des décès d’enfants au Manitoba sur la période de l’étude. Une proportion plus élevée d’enfants vivant dans les communautés rurales et nordiques est décédée de causes non naturelles. Les accidents de la route ont représenté la majorité des accidents, lesquels ont atteint un sommet en 1999. Pour les suicides, qui ont atteint un sommet en 2005, les pendaisons dans le groupe des 15 à 18 ans ont représenté presque la totalité des cas. Pour les homicides, les décès résultant de la maltraitance d’enfants de <3 ans étaient la cause la plus fréquente. Pour toutes les causes de décès, la plupart des sujets ont été trouvés morts sur les lieux ou sont décédés peu après.

CONCLUSIONS: La plupart des décès d’enfants de causes non naturelles au Manitoba pourraient être évités par la sensibilisation aux stratégies de prévention et par le redressement des iniquités sociales. L’amélioration du transport à l’hôpital à partir des endroits éloignés aurait sans doute peu d’impact sur la survie.

Mots clés

épidémiologie traumatismes mort adolescent pendaison accidentel 

References

  1. 1.
    Statistics Canada. CANSIM database Table 102-0561 — Leading causes of death, total population, by age group and sex, Canada, annual. 2009. Available at: http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=1020561 (Accessed January 20, 2013).Google Scholar
  2. 2.
    UNICEF. A League Table of Child Deaths by Injury in Rich Nations, Innocenti Report Card No.2. Florence, Italy: UNICEF Innocenti Research Centre, February 2001.Google Scholar
  3. 3.
    SMARTRISK. The Economic Burden of Injury in Canada. Toronto, ON: SMARTRISK, 2009.Google Scholar
  4. 4.
    Chen Y, Mo F, Yi QL, Jiang Y, Mao Y. Unintentional injury mortality and external causes in Canada from 2001 to 2007. Chronic Dis Inj Can 2013;33(2):95–102.PubMedGoogle Scholar
  5. 5.
    Martens PJ, Derksen S. A matter of life and death for Manitoba’s children: An overview of birth rates and mortality rates. Can J Public Health 2002;93(Suppl 2):S21–26.PubMedGoogle Scholar
  6. 6.
    Statistics Canada. CANSIM database Table 102-0510 — Deaths subject to autopsy. 2009. Available at: http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=1020561 (Accessed November 3, 2012).Google Scholar
  7. 7.
    Martens P, Brownell M, Au W, MacWilliam L, Prior H, Schultz J, et al. Health Inequities in Manitoba: Is the Socioeconomic Gap Widening or Narrowing Over Time? Winnipeg, MB: Manitoba Centre for Health Policy, 2010.Google Scholar
  8. 8.
    Brownell M, De Coster C, Penfold R, Derksen S, Au W, Schultz J, et al. Manitoba Child Health Atlas Update. Winnipeg: Manitoba Centre for Health Policy, 2008.Google Scholar
  9. 9.
    Chen W-H. Comparing low income of Canada’s regions: A stochastic dominance approach. Table 5, Headcount low-income rankings for selected low-income lines, 2000. Statistics Canada. 2008. Available at: http://www.statcan.gc.ca/pub/75f0002m/75f0002m2008006-eng.pdf.Google Scholar
  10. 10.
    Bristow KM, Carson JB, Warda L, Wartman R. Childhood drowning in Manitoba: A 10-year review of provincial Paediatric Death Review Committee data. Paediatr Child Health 2002;7(9):637–41.CrossRefGoogle Scholar
  11. 11.
    MacNeil MS. An epidemiologic study of aboriginal adolescent risk in Canada: The meaning of suicide. J Child Adolesc Psychiatr Nurs 2008;21(1):3–12.CrossRefGoogle Scholar
  12. 12.
    Malchy B, Enns MW, Young TK, Cox BJ. Suicide among Manitoba’s aboriginal people, 1988 to 1994. CMAJ 1997;156(8):1133–38.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Katz LY, Au W, Singal D, Brownell M, Roos N, Martens PJ, et al. Suicide and suicide attempts in children and adolescents in the child welfare system. CMAJ 2011;183(17):1977–81.CrossRefGoogle Scholar
  14. 14.
    Luo ZC, Wilkins R, Heaman M, Martens P, Smylie J, Hart L, et al. Birth outcomes and infant mortality by the degree of rural isolation among first nations and non-first nations in Manitoba, Canada. J Rural Health 2010;26(2):175–81.CrossRefGoogle Scholar
  15. 15.
    Karmali S, Laupland K, Harrop AR, Findlay C, Kirkpatrick AW, Winston B, et al. Epidemiology of severe trauma among status Aboriginal Canadians: A population-based study. CMAJ 2005;172(8):1007–11.CrossRefGoogle Scholar
  16. 16.
    Brownell M, Friesen D, Mayer T. Childhood injury rates in Manitoba: Socioeconomic influences. Can J Public Health 2002;93(Suppl 2):S50–56.PubMedGoogle Scholar
  17. 17.
    Canadian Institute for Health Information. Injury Hospitalizations and Socio-Economic Status. Ottawa, ON, 2010.Google Scholar
  18. 18.
    Pan SY, Desmeules M, Morrison H, Semenciw R, Ugnat AM, Thompson W, et al. Adolescent injury deaths and hospitalization in Canada: Magnitude and temporal trends (1979–2003). J Adolesc Health 2007;41(1):84–92.CrossRefGoogle Scholar
  19. 19.
    Condello AS, Hancock BJ, Hoppensack M, Tenenbein M, Stewart TC, Kirwin D, et al. Pediatric trauma registries: The foundation of quality care. J Pediatr Surg 2001;36(5):685–89.CrossRefGoogle Scholar
  20. 20.
    Warda L, Tenenbein M, Moffatt ME. House fire injury prevention update. Part I. A review of risk factors for fatal and non-fatal house fire injury. Inj Prev 1999;5(2):145–50.CrossRefGoogle Scholar
  21. 21.
    SMARTRISK. The Economic Burden of Unintentional Injury in Manitoba. Toronto: SMARTRISK, 2003.Google Scholar
  22. 22.
    Statistics Canada. CANSIM database Table 102-0552 — Deaths and mortality rate, by selected grouped causes and sex, Canada, provinces and territories, annual. 2009. Available at: http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=1020561 (Accessed November 3, 2012).Google Scholar
  23. 23.
    Skinner R, McFaull S. Suicide among children and adolescents in Canada: Trends and sex differences, 1980–2008. CMAJ 2012;184(9):1029–34.CrossRefGoogle Scholar
  24. 24.
    Austin AE, van den Heuvel C, Byard RW. Cluster hanging suicides in the young in South Australia. J Forensic Sci 2011;56(6):1528–30.CrossRefGoogle Scholar
  25. 25.
    Bernburg JG, Thorlindsson T, Sigfusdottir ID. The spreading of suicidal behavior: The contextual effect of community household poverty on adolescent suicidal behavior and the mediating role of suicide suggestion. Soc Sci Med 2009;68(2):380–89.CrossRefGoogle Scholar
  26. 26.
    Wissow LS, Walkup J, Barlow A, Reid R, Kane S. Cluster and regional influences on suicide in a Southwestern American Indian tribe. Soc Sci Med 2001;53(9):1115–24.CrossRefGoogle Scholar
  27. 27.
    Swanson SA, Colman I. Association between exposure to suicide and suicidality outcomes in youth. CMAJ 2013;185(10):870–77.CrossRefGoogle Scholar
  28. 28.
    Pollanen MS, Smith CR, Chiasson DA, Cairns JT, Young J. Fatal child abuse-maltreatment syndrome. A retrospective study in Ontario, Canada, 1990–1995. Forensic Sci Int 2002;126(2):101–4.CrossRefGoogle Scholar
  29. 29.
    Ogrodnik L. Child and Youth Victims of Police-reported Violent Crime, 2008. Ottawa, ON: Statistics Canada, 2010. Catalogue no. 85F0033M, no. 23.Google Scholar
  30. 30.
    Moon RY. SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleeping environment. Pediatrics 2011;128(5):1030–39.CrossRefGoogle Scholar
  31. 31.
    Byard RW. Changing infant death rates: Diagnostic shift, success story, or both? Forensic Science, Medicine, and Pathology 2013;9(1):1–2.CrossRefGoogle Scholar
  32. 32.
    Pan SY, Ugnat AM, Semenciw R, Desmeules M, Mao Y, Macleod M. Trends in childhood injury mortality in Canada, 1979–2002. Inj Prev 2006;12(3):155–60.CrossRefGoogle Scholar
  33. 33.
    Brownell M, Mayer T, Martens PJ, Kozyrskyj A, Fergusson P, Bodnarchuk J, et al. Using a population-based health information system to study child health. Can J Public Health 2002;93(Suppl 2):S9–S14.PubMedGoogle Scholar
  34. 34.
    Public Health Agency of Canada. Child and Youth Injury in Review, 2009 Edition — Spotlight on Consumer Product Safety. Ottawa: PHAC, 2009.Google Scholar
  35. 35.
    Christianson-Wood J, Murray JL. Child Death Reviews and Child Mortality Data Collection in Canada. Ottawa: PHAC, 1999.Google Scholar
  36. 36.
    Campbell LA, Jackson L, Bassett R, Bowes MJ, Donahue M, Cartwright J, et al. Can we use medical examiners’ records for suicide surveillance and prevention research in Nova Scotia? Chronic Dis Inj Can 2011;31(4):165–71.PubMedGoogle Scholar
  37. 37.
    Anonymous. Canadian Coroner and Medical Examiner Database: Annual Report 2006 to 2008. Ottawa: Statistics Canada.Google Scholar

Copyright information

© The Canadian Public Health Association 2014

Authors and Affiliations

  • Jayantha C. Herath
    • 1
  • Saman Kalikias
    • 2
  • Susan M. Phillips
    • 1
  • Marc R. Del Bigio
    • 1
    Email author
  1. 1.Department of PathologyUniversity of Manitoba, and Diagnostic Services ManitobaWinnipegCanada
  2. 2.Faculty of Medicine (Postgraduate Medical Education)University of ManitobaWinnipegCanada

Personalised recommendations