Reduced Incidence of Child Injuries, Death, and Health Issues


The Child Care Development Fund (CCDF) identifies and defines health and safety standards, and the causes and/or factors protective against child injuries, death, and health problems. This includes infectious diseases, sudden infant death syndrome (SIDS), administration of medications, food and other allergic reactions, safety of the physical premises, shaken baby syndrome, abusive head trauma, child maltreatment, emergency preparedness, handling of hazardous materials, first aid and CPR, and child abuse and neglect.

This indicator, measured at the child level, can be calculated as the number of infants and toddlers (ages zero to three years) with reported injuries, health issues, or death in a given year, divided by the total number of infants and toddlers in a state/community.

The National Child Abuse and Neglect Data System (NCANDS) reported that in 2016 an estimated 1,750 children died from abuse and neglect. Of those child fatalities, 76.9% were children under age three and children under age one accounted for 44.4% of those deaths. In 2016, infant mortality was 583 deaths per 100,000 compared to 1980 when it was 1,288 per 100,000. The CDC/NSCH reported that an estimated 3.6 million children ages zero to four had injury-related emergency department visits in 2009–2010.

CCDF re-authorization requires states to make available, by electronic means, easily accessible provider-specific information showing results of monitoring and inspection reports, as well as the number of deaths, serious injuries, and instances of substantiated child abuse that occur in child care settings each year. To find your state’s child care licensing site, visit Child Care Aware.

Population estimates are available at the community level for some components of this indicator.

  • The County Health Rankings and Roadmaps website has data on the number of infant deaths and the infant mortality rate, by county and, when available, the infant mortality rate by race/ethnicity.
  • There are no population estimates at the community level for injuries or health issues for infants and toddlers. Some states, such as California, may have these data available by county. For communities with no population estimates available, it is recommended that the community first evaluate if there are relevant data being collected and for whom (i.e., which sub-populations), and work with those organizations to get access to aggregate-level data on the number of child injuries or children with defined health problems. Next, a community could work with local organizations to determine how this data collection might be able to be expanded to the larger community population. If it is determined that no data on this indicator are currently being collected, the community could work with local organizations, such as health care centers or pediatrician offices to consider collecting these data in a systematized manner that could be tracked over time.

Research Rationale

According to the CDC, accidental injuries and deaths among children are one of the greatest public health problems in the United States.1 Unintentional injuries account for nearly 40% of all deaths among children ages zero to 19 years.2 While child death rates continue to fall, death during the infancy period is much more likely than any other time period, with the death rate for children under age one being 11 times higher than the rate for teenagers (ages 15-19 years).

  • 1. Borse, N.N; Gilchrist, J.; Dellinger, A.M.; Rudd, R.A.; Ballesteros, M.F.; Sleet, D.A. CDC Childhood Injury Report: Patterns of Unintentional Injuries among 0— 19 Year Olds in the United States, 2000-2006.
  • 2. National Action Plan for Child Injury Prevention: An Agenda to Prevent Injuries and Promote the Safety of Children and Adolescents in the United States. (2012). U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Injury Prevention and Control.