Citation

Pierce MC, Kaczor K, Olszewski AE. Pediatrics 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, American Academy of Pediatrics)

DOI

10.1542/peds.2022-056501

PMID

35843993

Abstract

In this issue of Pediatrics, Rebbe et al1 used a population-based linked administrative data set to analyze data on nearly 4000 children <3 years of age who were hospitalized for child maltreatment. The study used diagnostic codes that were specific for, or suggestive of, maltreatment. The main findings identified that a disproportionate number of children with public health insurance (used as a proxy for poverty) were reported to Child Protective Services (CPS) as compared to children with private insurance, and this was true within each maternal race and ethnicity category.

FINDINGS regarding race and ethnicity showed that fewer children of Asian or Pacific islander mothers were reported to CPS as compared to White mothers, and children with American Indian mothers were more likely to have a diagnostic code specific (rather than suggestive) for maltreatment as comparted to all other groups. The authors interpreted these findings of disproportionality to indicate that children and families of lower socioeconomic status (SES) may be more closely scrutinized for maltreatment than those of higher SES, and that race and ethnicity is also a likely factor in CPS reporting and diagnosing abuse. The authors speculate that clinician implicit bias was a key driver behind the disproportionalities. They conclude that programs and policies are needed to prevent the inequitable way children receive protective interventions so that race and poverty "do not impact these crucial decision points regarding the intervention of child maltreatment."

Whether race and ethnicity or SES biases (implicit or otherwise) were the drivers behind the disproportionality cannot be ascertained directly from this data set because of key limitations...

Language: en