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The influence of driver licensure on child motor vehicle crash (MVC) deaths in Kansas was investigated. Fatalities from 1994-2000 due to MVCs were extracted from the Kansas State Child Death Review Board and the Fatality Analysis Reporting Systems databases. It was found that 14% (52 of 363) of child fatalities from MVCs in Kansas occurred in vehicles where the driver was not licensed. Driver licence status was associated with use of safety restraints, the victim's age and race, weekend driving and rural county location. All child deaths involving unlicensed drivers were preventable. New legislation on vehicle sanctions may be required to assist law enforcement. Safety restraint laws should be enforced and promoted to the public. Transportation options are necessary for unlicensed drivers, particularly if they have young children and live in a rural community. Thus, a multi-system approach involving law enforcement, accident prevention strategies and transportation options will save the lives of children.

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Background. The purpose of this investigation was to review each school-associated child death in Kansas. No statewide studies of school-associated child death, regardless of cause, were found in the literature. This report details all-cause school-associated mortality in Kansas children during a 13-year period. Methods: Files for all school-associated child deaths (ages birth through 17) were compiled for the calendar years 1994 through 2006. Data files were provided by the Kansas State Child Death Review Board. Annual census data from the Kansas State Department of Education were obtained to determine annual student death rates. Data extracted from each file included: gender, race, year of death, age at death, manner of death, cause of death, whether an autopsy was performed, and whether the death was preventable. Results: A total of 26 school-associated deaths occurred in Kansas children over the study period. The school-associated death rate averaged 0.402 per 100,000 students per year. The median number of student deaths per academic school year was two. Thirty-one percent of all school-associated deaths were sudden cardiac deaths. Sixty-five percent of all deaths occurred during or shortly after participating in a physical activity or in sports. Conclusions: School-associated child deaths are rare events. However, the majority of deaths were preventable through better parental or school supervision, better communication with the school about student health issues, and safety education, especially related to sports activities and transportation. KJM 2009; 2(3):52-61.