Role of a child death review team in a small rural county in California.

Humboldt County is one of California's most rural counties. Located in far Northern California, it is 6-7 h by car from the nearest major urban areas of San Francisco and Sacramento. In landmass it is one of the largest of the California counties, about the size of Rhode Island. In 1991, the Humboldt County Public Health Branch began a Fetal Infant Mortality Review programme. Because of the county's small size, the Fetal Infant Mortality Review process was combined with the review of child deaths through age 17. Responding to a high proportion of cases of child deaths due to unintentional injury, the team developed a workgroup to explore injury prevention strategies. Funding was identified to hire a coordinator who formed a Childhood Injury Prevention Program and developed a strategic plan. The plan prioritised both motor vehicle/traffic safety related injuries and general childhood injury. Funding was obtained for child passenger safety and youth safe driving programmes. The Childhood Injury Prevention Program also collaboratively addressed other injury prevention areas, including water safety. As a small, rural county in California, committed safety advocates from multiple agencies were able to utilise the child death review process to guide injury prevention efforts. Case reviews provided the motivation and quantitative and qualitative data to design programmes and implement interventions that addressed specific unintentional injuries causing child deaths and injuries in Humboldt County.