Black children are more likely to be evaluated for abuse than white children with comparable injuries, according to a new study from The Children's Hospital of Philadelphia, raising concerns some children are being subjected to unnecessary testing while other cases of abuse go undiagnosed.
The study, which appears online today in the journal Pediatrics, looked at 3,063 infants admitted to 39 different pediatric hospitals with traumatic brain injuries not related to car accidents. The researchers compared the race and economic status of families with the subsequent diagnosis of child abuse after traumatic brain injury. Black families and families with governmental insurance were more likely to come under scrutiny than white families and families with private insurance.
"These results show a need for the development and implementation of standard guidelines regarding who gets evaluated for abuse and neglect so we avoid these biases," said study leader Joanne N. Wood, M.D., M.S.H.P., a pediatric researcher at The Children's Hospital of Philadelphia. "The concern is that we may subject children who are not getting abused to unnecessary tests and also miss actual abuse cases. We know from other studies that when physicians fail to recognize and diagnose abuse, children may suffer further abuse that results in more injury or even death."
Infants under one year of age are mostly likely to experience and die from child abuse and neglect. About one in 45 infants were victims of child abuse and neglect in the U.S. in 2007 and more than 700 died that year as a result.
In the study, a little more than one-third of the infants received a diagnosis of child abuse. Black infants and publicly insured or uninsured infants were more likely to undergo tests such as skeletal surveys. However, white children were more likely to receive a diagnosis of child abuse once a skeletal survey was ordered.