Black children injured due to suspected child abuse are reported to Child Protective Services more often than white or other race children, says new Stanford Medical College study I found.
Parents and other caregivers rarely admit to having harmed their children, so some of the reporting relies on the intuition of the provider, which can be influenced by unconscious and systemic biases. Researchers say there is potential. Health care workers are “mandated reporters” who must alert authorities if they believe a child may be the victim of abuse.
Potentially biased decisions by doctors and nurses about which injuries should be reported to Child Protective Services have led to an increase in investigations of black families and the abuse of white children whose incidents have not been reported to authorities. There may be more episodes.
The study also found that black child injuries are still disproportionately reported as suspected abuse regardless of whether the child is poor. A Stanford University study looked at whether children had public or private insurance as an indicator of family income.
The researchers used two sets of data on approximately 800,000 injuries sustained by children ages 1 to 17 from 2010 to 2014 and 2016 to 2017. This data was obtained from the National Trauma Data Bank maintained by the American College of Surgeons. Data showed that 1% of injuries were suspected to have been caused by abuse, based on medical codes used to report various types of abuse.
The end for abused children is tragic. Compared with the general population of traumatized children, victims of suspected child abuse are younger (median age 2 years compared to 10 years) and more likely to have public insurance. (77% vs. 43%) are more likely to be hospitalized. Intensive care unit (68% vs 48%). Victims of suspected child abuse were also 10 times more likely to die in hospital than the general population of traumatized children, and 8.2% of suspected abuse victims 0.84% of all children with malaria died while in hospital. Research found.
Of suspected child abuse victims, 1% were Asian, 0.3% were Native Hawaiian/Pacific Islander, 2% were Native American, and 12% were of other races, with suspected child abuse groups The proportion of children with pneumonia and those in the general population of injured children were similar. said the researchers.
However, black patients were disproportionately overrepresented among suspected child abuse victims. They made up 18% of the general population of children. Caucasian children made up 51% of suspected victims of child abuse and 66% of traumatized children in the general population.
Some experts say the disproportionate reporting of injured black children isn’t that medical professionals are being stigmatized, it just reflects that families tend to have lower incomes. However, the Stanford study did not believe it to be true.
“Even when we control our income, in this case through types of insurance, African-American children are still significantly overrepresented as suspected victims of child abuse.” said senior study author Stephanie Chao, PhD, assistant professor of surgery at Stanford Medicine.
Black child injuries were also reported to authorities when the injury severity score was low. This means that among the black racial group, suspicion of children with less serious injuries was stronger.
The opposite was true for white victims of child abuse. Health professionals overall had a higher threshold for suspicion of white family members of abuse and a lower threshold for suspicion of black families. However, researchers found that white children in groups of suspected abusers were more likely to be injured and admitted to intensive care units than black children.
White suspected child abuse patients had more severe injuries and had an in-hospital mortality rate of 9% compared with 6% for black patients, whereas black suspected child abuse patients Length of hospital stay increased despite adjustment for
Chao said such medical prejudices based on race are harmful to both black and white children.
“Over-identifying suspected cases of child abuse unnecessarily separates children from their families and creates stress that lasts a lifetime. But child abuse is so deadly that if you miss one event, you can probably A white kid who thinks no way — you might send that kid back unprotected into a very dangerous environment.The consequences are truly sad and devastating for both sides.
To combat racial prejudice, Chao and her colleagues designed a universal screening system used by Stanford Medicine Children’s Health since 2019. This is assessed whenever a child under the age of 6 is injured in a private home. Electronic medical records automatically send alerts to the organization’s child abuse team. Pediatricians and social workers with specialized abuse detection training check medical records for other signs of abuse. If the medical record shows red flags, the staff who admitted the patient to the emergency department or hospital are alerted to consider whether further testing or reporting to Child Protective Services is necessary.
This fairer method of screening injured children helps protect against decisions made largely by the intuition of health care providers, Chao said.
She’s also working with Epic, the nation’s largest electronic medical record company, to integrate automated child abuse screening tools into their systems. The tool will be tested at multiple medical institutions later this year.
“Everyone has good intentions here, but the consequences of these reports being wrong are pretty dire in either direction. Failing to recognize bias and always chalking it up to something else If that’s the case, we can’t solve the problem in a thoughtful way. I hope that now we can recognize that and work towards a solution,” Chao said.
