PART ONE Assessing Your Readiness for Child Death Review 1. Define the geographic area that the team will cover (local, regional, state etc.): ______________________________________________________________________________ ______________________________________________________________________________ 2. What is the total population in your community? _________________________ How many children are age 18? _________________________ How many children are under age 10? _________________________ How many children are under age 5? _________________________ 3. What is the racial and ethnic makeup of your community? Group Percent Caucasian African American American Indian Hispanic Pacific Islander Asian 4. How many children, ages 0-18 died in the past calendar year of all causes? Age Number < 1 1-4 5-9 10-14 15-18 5. By what manner did the children die in the past year? Manner Number Natural Accidental/Unintentional Homicide
PART ONE Assessing Your Readiness for Child Death Review 1. Define the geographic area that the team will cover (local, regional, state etc.): ______________________________________________________________________________ ______________________________________________________________________________ 2. What is the total population in your community? _________________________ How many children are age 18? _________________________ How many children are under age 10? _________________________ How many children are under age 5? _________________________ 3. What is the racial and ethnic makeup of your community? Group Percent Caucasian African American American Indian Hispanic Pacific Islander Asian 4. How many children, ages 0-18 died in the past calendar year of all causes? Age Number < 1 1-4 5-9 10-14 15-18 5. By what manner did the children die in the past year? Manner Number Natural Accidental/Unintentional Homicide
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