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Promoting Health Equity for Children With Special Health Care Needs and Child Welfare Involvement
Amanda A Simard1, Emma Gerstenzang2, Sarah Gerstenzang3
1Department of Pediatrics, New York-Presbyterian Morgan Stanley Children's Hospital/Columbia University Irving Medical Center, New York, New York.
Hospital Pediatrics
|January 15, 2025
Summary
Racism contributes to discharge delays for children with special health care needs in the child welfare system. Addressing systemic inequities is crucial for equitable family-centered care and preventing cycles of oppression.
Area of Science:
- Pediatric health equity
- Child welfare system disparities
- Social determinants of health
Background:
- Children with special health care needs (CSHCN) and their families can face significant challenges navigating healthcare and social services.
- Racial disproportionality is evident within the child welfare system, with Black children being disproportionately involved.
Purpose of the Study:
- To explore racism as a root cause of discharge delays for CSHCN involved with child protective services (CPS).
- To examine the origins and consequences of racial disproportionality in the child welfare system.
- To highlight the role of the healthcare system in perpetuating inequities.
Main Methods:
- Case study analysis of an infant with trisomy 21 and severe malnutrition.
- Exploration of existing literature on racism, child welfare, and healthcare inequities.
- Discussion of systemic factors contributing to racial disproportionality.
Main Results:
- Racial bias within the child welfare system can lead to delayed discharges for CSHCN.
- Disproportionate CPS involvement for Black families can undermine health, well-being, and trust in healthcare.
- Healthcare systems may inadvertently perpetuate racial disparities.
Conclusions:
- Pediatric providers have a critical role in mitigating racial disparities by adopting equitable, family-centered, and trauma-informed care practices.
- Addressing systemic racism in child welfare and healthcare is essential for improving outcomes for marginalized families.
- Advocacy for policy changes is needed to reduce racial disparities and support families involved with child welfare.
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