By Rose Hoban

Twenty-five years ago, North Carolina had the worst infant mortality rate in the country, and deaths to children under the age of 17 was at a high. There were a series of newspaper articles claiming that North Carolina was missing cases of child abuse that lead to dozens, perhaps hundreds of deaths.

As child welfare experts from around the state gathered to look at the data, they realized that deaths from abuse were only a small part of the numbers. There were plenty of other reasons that children were dying: automobile accidents, drownings, house fires, Sudden Infant Death Syndrome and other causes, along with some child abuse.

Rates of child death in North Carolina have dropped in the past two-and-a-half decades since the Child Fatality Task Force started work. Chart courtesy: CFTF

“In the process of getting everyone together, we realized this was an opportunity to do something about the broader area of child fatalities,” said John Butts, who was the state’s Chief Medical Examiner at the time.

“So we we basically came up with the idea of having a study done of all child fatalities over a certain period of time and then to have… a task force look at them and make recommendations as to how we could cut down the number of children dying from all the different risks children encounter.”

The Child Fatality Task Force was born. Originally, it was supposed to only last for two years, but the committee has received appropriations to continue long past the original mandate.

Many former task force members returned to the legislature Monday to celebrate a quarter century of bipartisan accomplishments, a process driven largely by volunteer work by legislators and subject-matter experts from around the state.

By their reckoning, about 16,000 children are alive today because of law and policy changes driven by the body.

“It’s critically important work,” said Jennifer Tolle Whiteside, a former chair of the CFTF in the 1990s.

Beyond child abuse

In the years since the establishment of the task force in 1991, the child death rate in North Carolina has dropped by 46 percent, from 107.6 deaths per 100,000 children down to 58.3 deaths per 100,000 in 2015.

The task force has supported training for child abuse investigations, pushed for required reporting to law enforcement by hospitals and physicians with suspicions of child abuse, and the creation of child protective services hotlines for each county.

Long-time Child Fatality Task Force member Tom Vitaglione shows off a car booster seat once used during a Senate debate during a celebration of the committee’s 25th year. Photo credit: Rose Hoban

Still, congenital conditions and infant illnesses are the largest killers of children under the age of 17, followed by motor vehicle injuries and other unintentional injuries, such as drowning and firearm accidents.

Former task force member Joel Rosch said at the time the group was forming, the data showed these types of injuries were bigger killers of children than abuse, and he pushed the group to focus on that.

“One of the reasons I think the task force has survived and been effective has been that we’ve moved away from this narrow focus of abuse… to more data driven things,” he said.

Rosch helped to lead the effort to institute graduated drivers licensing for teens, making North Carolina the second state in the country to do so. This has lead to a 37 percent drop in crashes by 16 year olds and a 14 percent drop in crashes by 17 year olds.

Mandatory car seats for children is another issue championed by the task force, said Tom Vitaglione, who headed child health services for the state back in the early 1990s.

Vitaglione pulled a child car seat out of a plastic bag when he got up to speak to the gathering.

“This is the booster seat that Sen. Purcell used in getting the legislation passed,” he said, chuckling. “His deskmate stole it from him, and when he reached down to get it, it wasn’t there. And it appeared in another part of the chamber.”

Wins and losses

Retiring Sen. Stan Bingham (R-Denton) regales the Child Fatality Task Force with a story of a legislative fight during his farewell address to the group. Looking on are (l to r) Rep. Craig Horn (R-Weddington), Buck Wilson and Karen McLeod. Photo credit: Rose Hoban

About a third of all deaths of kids under the age of 17 actually happen in the first year of life from causes that include birth defects, infant illnesses and Sudden Infant Death Syndrome. CFTF members claim some credit for creating policies to lower North Carolina’s stubbornly high infant mortality rate, including campaigns to have parents put their children on their backs to sleep, encouraging breastfeeding, and teaching parents how to better manage a crying child.

The group has also championed support for facilities such as the high risk maternity clinic at East Carolina University, funding for the drug 17-P which helps reduce the risk for preterm birth for some women, and money towards educational initiatives to improve health for reproductive-aged women.

Other states have taken similar actions and seen decreases similar to those in North Carolina. Yet even with the state’s progress in the reducing the infant mortality rate, it is still one of the highest rates in the country.

Not uncontroversial

At times, the task force’s advocacy for child safety issues has aroused ire at the legislature, for instance, when the committee called for firearm safety measures to reduce the number of accidental child deaths and suicides that take place using guns.

One of the recommendations from this year’s task force process will be to convene a workgroup of firearm safety stakeholders.

Retiring senator Stan Bingham (R-Denton), who’s been a long-time member of the task force, called it one of the strongest committees at the General Assembly.

“I’ve always enjoyed a fight and boy this is a place to start one,” he said, to laughter.

Bingham told of using the information from the CFTF to back measures to reduce the number of deaths from opiate overdose. He sponsored the Good Samaritan law in 2013, bills to make the opiate-antidote naloxone more widely available in 2015, and finally, a bill allowing for syringe and needle exchanges that passed last summer as the legislative session wound down.

“A lot of the bills passed on account of the fact the Child Fatality Task Force endorsed them,” he said. “And Tom [Vitaglione] would walk the halls with me, and we’d come up with strategies of who to talk to, who we were going to be fighting, who would help and not help.”

But those fights sometimes came with a cost, in particular in the 2013 session, when a move to eliminate the budget for the committee gained steam in the House of Representatives.

“A couple of years ago, the Legislature hit their head on something and wanted to get rid of this,” Bingham said. “And (retired Sen.) Austin Allran and I ran interference and kept it going and I hope that in another 50 years, it’ll still be here.”

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Rose Hoban

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...