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Disparities in Child Welfare Referrals for Patients Seen in a Pediatric Emergency Department for Unintentional

Joseph P Shapiro1, Elizabeth C Pino2, Annie Goodridge3

  • 1Department of Pediatrics (JP Shapiro, A Hoch, S Kendi, and TP Boyle), Boston Medical Center & Boston University Chobanian & Avedisian School of Medicine, Boston, Mass.

Academic Pediatrics
|January 22, 2024
PubMed

Insights

Pediatric emergency department visits for unintentional ingestions are common. Hispanic children are disproportionately referred to Child Protective Services (CPS) for neglect compared to White children.

Area of Science:

  • Pediatric Emergency Medicine
  • Child Maltreatment Research
  • Public Health

Background:

  • Unintentional ingestions are a frequent reason for pediatric emergency department (PED) visits.
  • Child Protective Services (CPS) referrals for neglect are a critical concern in pediatric healthcare.

Purpose of the Study:

  • To characterize patients presenting to the PED for unintentional ingestions.
  • To investigate associations between patient race/ethnicity and CPS referrals for neglect.

Main Methods:

  • Cross-sectional analysis of children under 12 years old presenting to the PED for unintentional ingestions (October 2015 - December 2020).
  • Data abstracted from electronic health records, including demographics, ingestion type, disposition, and CPS referrals.
  • Logistic regression models used to assess demographic associations with CPS referral.

Main Results:

  • 129 encounters analyzed; 17.1% resulted in CPS referral for neglect.
  • Ingestion of illicit drugs and ambulance arrival were associated with higher CPS referral odds.
  • Hispanic patients had significantly higher odds of CPS referral than White patients (aOR=17.2, P=.03).

Conclusions:

  • CPS referrals following unintentional ingestions are frequent and disproportionately affect Hispanic children.
  • Further research is needed to ensure equitable child maltreatment reporting in the PED setting.
Abstract

Keywords:
child protectioningestionspediatric emergencyracial disparitiessupervisory neglect

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