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Healthcare Utilization and Risk for Intentional Injury Death among Ohio Children Enrolled in Medicaid, 1992 – 1998

Stubblefield, Angelique Marie
http://rave.ohiolink.edu/etdc/view?acc_num=case1151593844

Abstract Details

2006, Doctor of Philosophy, Case Western Reserve University, Epidemiology and Biostatistics.
Background Child murder has been established in the literature to be mostly committed by parents (1-6). Specific maternal classifications have been shown to exist in samples from different cultures and different time periods. The studies tend to suggest that a history of mental health problems in the decedent’s mother is associated with intentional injury death, but further studies including comparison groups and non-homicidal mothers are needed to verify this implication. The goal of this work was to provide answers to the following questions: 1. Does a history of maternal psychiatric diagnoses increase the likelihood of having had a child who died by homicide? 2. Which child and maternal characteristics are risk factors for child homicide? Design This was a nested case control study of intentional injury deaths among low income children age 0-7. Children who died by intentional injury (n=84) were compared to (1) those who died by unintentional injury (n=187) and (2) to a random sample of children from the same population who did not die during the study period (n=420). Methods The study utilized linked Ohio Medicaid, death certificate (DC), and birth certificate (BC) files. Adjusted odds ratios were obtained using multivariable logistic regressions for all hypotheses. Results: Maternal psychiatric history was not significantly associated with homicide in either comparison. Stress or substance use diagnoses, in the absence of a psychiatric history, were not significantly associated with homicide in either comparison. Mothers with a history of injuries were significantly more likely to have had a child who died by homicide. Mothers with lower parity were significantly more likely to have had a child who died by homicide versus accident. Children who had traumatic brain injuries and eye conditions were significantly more likely to be victims of homicide in both comparisons. Conclusions and Policy Implications Medicaid programs have been implementing services that target women of childbearing age for improved prenatal and postnatal care. They should consider linking these families to services that assist with routine child care education, counseling, and domestic violence prevention services.
Mireya Diaz-Insua (Advisor)
178 p.
Child Injury; Homicide; Medicaid; Family Violence; Intentional Injury; Child Death

Recommended Citations

Citations

  • Stubblefield, A. M. (2006). Healthcare Utilization and Risk for Intentional Injury Death among Ohio Children Enrolled in Medicaid, 1992 – 1998 [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1151593844

    APA Style (7th edition)

  • Stubblefield, Angelique. Healthcare Utilization and Risk for Intentional Injury Death among Ohio Children Enrolled in Medicaid, 1992 – 1998. 2006. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1151593844.

    MLA Style (8th edition)

  • Stubblefield, Angelique. "Healthcare Utilization and Risk for Intentional Injury Death among Ohio Children Enrolled in Medicaid, 1992 – 1998." Doctoral dissertation, Case Western Reserve University, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=case1151593844

    Chicago Manual of Style (17th edition)

case1151593844
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© 2006, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.