Child Fatality/Near Fatality Ingestion Analysis

Current information

The 2008 Act 33 Amendment to the Pennsylvania Child Protective Services law requires state and local reviews of all child fatalities and near fatalities that result from suspected child abuse. In response, the Allegheny County Department of Human Services (DHS) conducts a comprehensive and multidisciplinary review of child fatalities and near fatalities in cases where there is suspicion of child abuse or neglect. These reviews are a component of DHS’s continuous quality improvement process.

This report covers child fatalities and near fatalities (critical incidents) in Allegheny County reviewed in 2022 and 2023 with a focus on drug ingestions, which have been a growing cause of these critical incidents. The increase in child ingestions and fatalities has been a nationwide trend in recent years and has worsened amidst the nation’s opioid epidemic. The County seeks to understand how these incidents happen and the circumstances surrounding them so that it can develop strategies to minimize them.

  • There were 50 critical incidents that occurred during 2022 and 2023. Forty percent (20) of these incidents were the result of unintentional drug ingestion. Unintentional ingestion comprised one-third of the 2022 incidents, rising to nearly one-half in 2023. The number of ingestion-related incidents has been rising year-over-year since 2019 and has been the primary cause of the County’s fatalities and near fatalities since 2022, surpassing blunt force or penetrating trauma and abusive head trauma.
  • In 18 of the 20 ingestion cases, at least one of the substances ingested was an opioid. Eighty-six percent of the near fatal and 100% of the fatal ingestions involved opioids.
  • The majority (70%) of ingestions occurred in children below the age of three. 40% of victims of ingestions were between one and two years of age compared to 27% of victims of non-ingestion fatalities and near fatalities. This age group are especially at risk for unintentional ingestion as they begin to gain mobility, which increases the likelihood of coming into contact with substances.
  • Only 4 (20%) families of ingestion-related critical incidents had active child welfare involvement at the time of the incident, though three quarters (15) of families had a history of child welfare involvement prior to the ingestion incident.
  • Sixty-six percent of alleged perpetrators in ingestion cases had received publicly funded substance use disorder services prior to the critical incident.  However, there was a reduction in engagement with these services within a year (43%) and within a month (36%) prior to the critical incident.
  • Of the known alleged perpetrators in ingestion cases, 41% had utilized medication for opioid use disorder (MOUD) at some point before the critical incident. There was a steady decrease in MOUD use leading up to the critical incident with 31% using MOUD within the year and 13% within the month prior to the critical incident

Allegheny County is taking an active role in addressing the ramifications of the opioid epidemic and the rising trend of unintentional ingestions. This includes enhanced training for Child welfare staff and access to naloxone, lockboxes and fentanyl test strips for caseworkers to provide to clients. The County, through its opioid settlement funds, has expanded convenient access to MOUD and evidence-based treatment (e.g., mobile medication, telemedicine prescribing, and incentives for abstinence from stimulants and opioids) and launched a Countywide marketing campaign in April 2024 warning about the dangers of opioid ingestions and the safety of administering naloxone to children. In addition, it has invested in preventative programming like residential substance use disorder treatment that allows families to reside together during a person’s treatment and in the Hello Baby approach, a collaboration which is designed for parents with newborns to improve family outcomes and maximize child and family well-being, safety and security.

Explore updated annual data and prior reports here.

Community Need Index

Current dataset and related materials

What is the Community Need Index?

The Allegheny County Department of Human Services (DHS) conducts a Community Need Index (CNI) to identify specific areas that are in greater need, and face larger socioeconomic barriers, relative to others. The newest version of the CNI index ranks neighborhoods by need level by looking at:

  • The percentage of families who live below the poverty line
  • The percentage of unemployed or unattached males
  • The percentage of those aged 25 and up without at least a Bachelor’s degree
  • The percentage of single parent households
  • The percentage of households without internet access
  • Rate of homicide per 100,000 residents
  • Rate of fatal overdoses per 100,000 residents

The researchers used a census tract level to break up the region and assess needs. Census tracts are static, relatively small subdivisions of a county.

How can I view the findings?

An interactive map allows users to view and extract data from the 2024 CNI (which uses 2022 five-year data estimates and totals). The new report focuses on all of Allegheny County, examines changes in need over time, and places emphasis on the connection between race and community need. Earlier reports are linked below.

What are the takeaways?

  • In Allegheny County, we continue to find the highest levels of need in specific sections of the City of Pittsburgh (Hill District, South Hilltop, parts of the West End, Upper East End neighborhoods, Upper Northside) as well as census tracts outside the City of Pittsburgh (Mon Valley, sections of the Allegheny County River Valley, sections of Penn Hills, sections of Wilkinsburg, Stowe-Rocks).
  • There are vast discrepancies between the lowest need communities, which have an average poverty rate of 2%, and the highest need communities, where the average poverty rate is 38%.
  • With few exceptions, census tract-level community need is persistent over time.
  • Only about one-third of Allegheny County’s Black residents live in lower-need communities. For every other racial and ethnic group in the County, the majority of residents live in lower need communities. Black communities in Allegheny County have disproportionately high levels of need, as do a number of racially mixed communities. 
  • Poverty status alone does not account for where various racial and ethnic groups tend to live by level of need; poor Black and Latino families are more likely than other poor families to live in higher need communities. Even Black families above the poverty line are many times more likely than their Asian, White and Latino peers above the poverty line to live in higher need communities.

How is this report used?

The geographic dimensions of community need can help inform many aspects of DHS’s strategic planning and resource allocation decisions, such as decisions on where to locate Family Centers or new after-school programs.

Where can I go for more information?

For more information, you can read previous reports below. Or you can reach out to DHS-Research@alleghenycounty.us with any questions.

 


Previous reports in this series 

Previous datasets in this series

DHS Goals and Key Initiatives: 2024

Current information

DHS has set five goals to guide us and our partners in serving our community well. We aim for our network for human services to improve access to care, prevent overuse of coercive services, prevent harm, increase economic security and ensure quality.

What is this report about?

DHS can reach our goals more quickly if we devote time and attention to several big, bold initiatives that will make our systems and our organization work better for everyone we serve. This document outlines our key initiatives in 2024—which are in addition to our core work of running effective systems of care for people.

DHS 2023 Accomplishments

Current information

County human services includes programs from over 300 community-based agencies and is delivered by social workers, peers, and outreach staff working all throughout the county. These staff run out-of-school-time programs, answer hotlines, investigate reports of potential harm to children and vulnerable adults, deliver meals to seniors and run Senior Centers, make home visits to families with newborns, and do the administrative work that makes our human services run efficiently.

What is this report about?

This report highlights the 2023 accomplishments that stood out. There are many, many other achievements that people told us about. We chose the ones that made the biggest difference.

Current Information

Allegheny County DHS sends text messages to county residents for a variety of reasons, including increasing awareness of services, providing timely reminders, and gathering feedback after a service experience.  In addition, DHS uses this information to help evaluate and monitor programs it delivers.  This dashboard displays information about these outreach and engagement efforts, including the subject and purpose of these and the rates of engagement.  Data on DHS’s texting efforts are available from November 2017 to the present.

The dashboard allows users to examine DHS text messaging as a whole as well as drill down to individual text campaigns.  It allows users to understand the purpose of each campaign, the number of messages sent and the demographics of the people being contacted by each campaign.  DHS collects this information through Community Connect Labs (CCL), DHS’s texting software, and information is updated daily. Click here for a more detailed report on DHS’s texting outreach from 2018-2022.

COVID-19 Community Learning Hubs

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The COVID-19 pandemic forced schools to shift to remote learning models, causing challenges related to childcare and access to education. In response, the Allegheny County Department of Human Services (DHS), Trying Together, and the United Way partnered with out-of-school time providers and community-based organizations to open Community Learning Hubs. Opened in September 2020, the Hubs provided a free place for students to engage in virtual learning. Forty-nine providers operated 75 Hub locations that offered schoolwork support, technology troubleshooting, high-speed internet access, and meal distribution in a safe, supervised environment. This report provides data about student demographics, the school districts involved, and attendance trends.

The presence of police officers in schools has become increasingly common since the practice was introduced in the 1950s. While law enforcement in schools may deter criminal behavior, it can also have the effect of increasing youth juvenile justice system involvement. Allegheny County Department of Human Services (DHS) wanted to learn more about youth arrests in Pittsburgh, particularly differences related to where an allegation happens — in or out of school — and how the outcomes of students involved with the juvenile justice system differ from those who have not been involved. We also wanted to know more about students’ involvement with human services in order to better understand where there might be gaps in services and supports for students involved with juvenile justice.

To explore these questions, we took a descriptive longitudinal look at students who were registered in Pittsburgh Public Schools (PPS) in school year 2010 and followed them through 2018.

What we found:

  • One out of four middle and high school students who attended Pittsburgh Public Schools in the 2010 school year had at least one allegation in juvenile court during the study period. Of those allegations, 37% were made by PPS police.
  • Eighty percent of students with allegations were Black, while only 58% of the total student body was Black. The rate of disproportionately was similar for allegations made by school police and those made outside of school.
  • Allegations made by PPS police were much more likely to be for lower-level offenses than allegations outside of school, but more than half of students with either type of allegation had involvement with the adult criminal justice system later on.
  • Students with an allegation had a higher number of school absences and suspensions throughout their time in school than those with no allegations.
  • Students with an allegation were more likely than other students to be involved with the child welfare system, mental health services and live in assisted housing.

In recent years, PPS has put in place programs to divert students from the criminal justice system as well as implement restorative justice practices in schools, which we hope will lead to a reduction in disproportionality and improved outcomes for students.

 

Click here to view the full report. 

 

The National Center for Education Evaluation and Regional Assistance at the Institute of Education Sciences (US Department of Education) examined data from Allegheny County students to better understand predictors of near-term academic risks. The goal of this research to provide information for administrators, researchers, and student support staff in local education agencies who are interested in identifying students who are likely to have near-term academic problems such as absenteeism, suspensions, poor grades, and low performance on state tests.

What is this report about? 

The report describes an approach for developing a predictive model and assesses how well the model identifies at-risk students using data from two local education agencies in Allegheny County, Pennsylvania: a large local education agency and a smaller charter school network. It also examines which types of predictors— in-school variables (performance, behavior, and consequences) and out-of-school variables (human services involvement and public benefit receipt)—are individually related to each type of near-term academic problem to better understand why the model might flag students as at risk and how best to support these students.

What are the takeaways?

The study finds that predictive models using machine learning algorithms identify at-risk students with moderate to high accuracy. In-school variables drawing on school data are the strongest predictors across all outcomes, and predictive performance is not reduced much when out-of-school variables drawing on human services data are excluded and only school data are used. However, some out-of-school events and services—including child welfare involvement, emergency homeless services, and juvenile justice system involvement —are individually related to near-term academic problems. The models are more accurate for the large local education agency than for the smaller charter school network. The models are better at predicting low grade point average, course failure, and scores below the basic level on state tests in grades 3–8 than at predicting chronic absenteeism, suspensions, and scores below the basic level on high school end-of-course standardized tests. The findings suggest that many local education agencies could apply machine learning algorithms to existing school data to identify students who are at risk of near-term academic problems that are known to be precursors to school dropout.

When a child is placed in a foster home, the resulting move can also mean living in a new school district. Research has shown that unplanned school changes can lead to worse educational outcomes, such as lower test scores and graduation rates. A 2015 federal mandate, the Every Student Succeeds Act, requires that children in child welfare placements remain in their home school – unless it is determined not to be in the student’s best interest – so as to maximize a student’s stability and educational outcomes.

In response, the Allegheny County Department of Human Services took advantage of a wealth of data and strong school partnerships to develop a collaborative, child-centered process that helps children in child welfare placements maintain school stability whenever possible. The result was hundreds of students continuing to attend their home school in the 2016-17 school year.

Read the full report to learn about how DHS responded, challenges we faced, and results from the first year of implementation.

Child welfare out-of-home placements are stressful events, compounded by the fact they may result in a youth changing schools. Research shows mid-year school changes to be disruptive both academically and socially. This report examines child welfare imposed mobility, identifying system challenges as well as the positive factors that have led to an overall decrease in these system-imposed school moves.

Click to read the full data brief. 

Content and analysis: Emily Kulick and Samantha Murphy
Writer: Jeffery Fraser

By the spring of 2015, 16 school districts, Propel Schools and the Allegheny Intermediate Unit had signed legal agreements with the Department of Human Services (DHS), allowing data to be shared on a level never before possible.

This publication describes the way in which DHS’s partnerships with local school districts continued to expand and enabled us to focus on specific issues, such as homelessness, greater collaboration between human services and school social workers, and faster and more through identification of students in need.

Click here to read the report.

Click here to read Improving Outcomes and Well Being: August 2013 Update.

Schools districts and human service systems define homelessness differently (as mandated by their respective regulatory and funding entities), resulting in many youth who are known to only one system. While being homeless is a disruptive experience that often hurts educational achievement, homeless youth are afforded additional supports to counteract these impacts. This report examines the misalignment in the two homeless populations, examining the underlying reasons as well as the potential solutions that would allow both schools and the human services agency to support the larger homeless population.

Click to read the full data brief. 

Writer: Jeffery Fraser
Research and content: Sanjeev Baidyaroy, Emily Kulick and Erin Dalton

Intensive supervision programs like school-based probation are increasingly viewed as a way to generate savings to society, by preventing or reducing the likelihood of crime, as well as to improve outcomes for the juvenile offenders through an emphasis on education and employment opportunities. Allegheny County examined a number of outcomes for Pittsburgh Public School students under school-based probation before, during and after supervision, including participation in social services, educational outcomes, and future involvement in the juvenile and criminal justice systems. Of the students in school-based probation, more than 70 percent improved attendance during supervision and over 40 percent improved their Grade Point Average (GPA).  Interestingly, for students charged with misdemeanors, those who recidivate have more than double the absence rate during supervision than those who do not re-offend.

Click to read the full report.

Prepared by: Kathryn Collins, Ph.D., Erin Dalton and Emily Kulick

Addressing School Absenteeism

An increased focus on school attendance has led to the implementation of a number of strategies designed to reduce absenteeism and its related impact on academic outcomes. The implications of chronic absenteeism are particularly relevant for students involved in human services, who account for a disproportionate number of chronically absent students.
This brief addresses the impact of absenteeism on students and describes the various local efforts to improve school attendance.

Click to read the data brief.