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Black children are overreported as suspected victims, at a rate of 2.5 times their proportion in the overall U.S. population

Black children with traumatic injuries are overreported as suspected victims of child abuse, according to a study published in the February issue of the Journal of Pediatric Surgery.

Modupeola Diyaolu, M.D., from the Stanford University School of Medicine in California, and colleagues assessed whether racial disparities exist in the identification of child abuse. The analysis included 798,353 patients (ages 1 to 17 years) identified in the National Trauma Data Bank (2010 to 2014 and 2016 to 2017).

The researchers found that 1 percent of patients were suspected child abuse (SCA) victims (7,903). Black patients were disproportionately overrepresented, accounting for 33 percent of SCA patients despite being 12 percent of the U.S. population. White SCA patients were more severely injured (Injury Severity Score [ISS], 16 to 24: 20 versus 16 percent) and had higher in-hospital mortality (9 versus 6 percent). Yet, Black SCA patients had longer hospitalizations (7.2 versus 6.2 days) even when controlling for ISS (1 to 15: 5.7 versus 4.2 days). In multivariate regression, the longer hospitalization trend continued for Black children after also controlling for insurance type.

“In this study using a nationally representative database of injured children, we observed that Black children were significantly overrepresented among suspected child abuse victims at a rate of 2.5 times their proportion in the overall U.S. population. We found this trend to be persistent, even when controlling for socioeconomic factors using payer type,” the authors write. “Further studies are needed to better understand the etiology of the observed trends and whether they reflect potential underlying unconscious or conscious biases of mandated reporters.”

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