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Racial and Ethnic Disparities in Child Abuse Identification and Inpatient Treatment
Fereshteh Salimi-Jazi1, Norah E Liang1, Zhuoyi Huang1
1Division of Pediatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California.
JAMA Network Open
|December 18, 2024
Summary
Black children and adolescents show higher rates of suspected child abuse compared to other racial groups. Further research is needed to understand and reduce these disparities in identification.
Area of Science:
- Pediatric Trauma
- Child Abuse Identification
- Health Disparities
Background:
- Child abuse is a significant cause of childhood morbidity, yet accurate detection remains a challenge.
- Racial and ethnic disparities in the suspicion for child abuse (SCA) among pediatric trauma patients require investigation.
Purpose of the Study:
- To describe racial and ethnic disproportionalities in the suspicion for child abuse (SCA) among pediatric patients admitted after traumatic injury.
- To analyze the association between race/ethnicity and SCA in pediatric trauma cases.
Main Methods:
- Retrospective, multicenter cross-sectional study using the Kids' Inpatient Database (KID) from 2006-2019.
- Analysis of a national sample of children (<18 years) admitted for pediatric trauma, comparing demographics, injury severity, and hospitalization characteristics by race and ethnicity.
- Identification of SCA cases using ICD-9-CM and ICD-10-CM codes for child maltreatment.
Main Results:
- Among 634,309 pediatric trauma patients, 13,579 had SCA. Black and Hispanic patients were overrepresented in the SCA subgroup compared to the US Census.
- After controlling for socioeconomic factors, Black race remained an independent risk factor for SCA (OR, 1.10), while Hispanic race showed a protective association (OR, 0.71).
- Black patients with SCA experienced significantly longer lengths of stay compared to White patients with similar injury severity.
Conclusions:
- Black children and adolescents exhibit higher rates of suspected child abuse following traumatic injury compared to other racial and ethnic groups.
- Significant racial and ethnic disparities exist in child abuse identification, with Black children being disproportionately affected.
- Further research is essential to elucidate the origins of these disparities and develop strategies for equitable child abuse identification.
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