OBJECTIVES: To measure empirically the influence of race and socioeconomic status (SES) on the diagnosis of child abuse and willingness to report to child protection services. STUDY DESIGN: A total of 5000 pediatricians randomly selected from the American Medical Association's Masterfile received 1 of 4 randomly assigned versions of afictional clinical presentation of a child (black/white + high SES/low SES) that described an unwitnessed event in a mobile 18-month-old child resulting in an oblique femur fracture. Outcome measures included ranking the degree to which the injury was accidental versus abuse and agreement with reporting the injury to child protection services. RESULTS:A total of 2109 of 4423 physicians responded (47.7%). Patient's race did not have an effect on a diagnosis of abuse (black, 45% versus white, 46%). Abuse was more likely to be diagnosed in patients with low SES (48% versus 43%, overall P = .02). CONCLUSION: This study supports earlier work demonstrating physicians' greater willingness to consider abuse as a potential cause of injury in low SES children. It failed to demonstrate the finding of retrospective, real world studies of an increased likelihood to consider abuse in black patients. Future work should try to understand why there remains a differential approach to evaluating minority children for abuse in real world settings.
RCT Entities:
OBJECTIVES: To measure empirically the influence of race and socioeconomic status (SES) on the diagnosis of child abuse and willingness to report to child protection services. STUDY DESIGN: A total of 5000 pediatricians randomly selected from the American Medical Association's Masterfile received 1 of 4 randomly assigned versions of a fictional clinical presentation of a child (black/white + high SES/low SES) that described an unwitnessed event in a mobile 18-month-old child resulting in an oblique femur fracture. Outcome measures included ranking the degree to which the injury was accidental versus abuse and agreement with reporting the injury to child protection services. RESULTS: A total of 2109 of 4423 physicians responded (47.7%). Patient's race did not have an effect on a diagnosis of abuse (black, 45% versus white, 46%). Abuse was more likely to be diagnosed in patients with low SES (48% versus 43%, overall P = .02). CONCLUSION: This study supports earlier work demonstrating physicians' greater willingness to consider abuse as a potential cause of injury in low SES children. It failed to demonstrate the finding of retrospective, real world studies of an increased likelihood to consider abuse in black patients. Future work should try to understand why there remains a differential approach to evaluating minority children for abuse in real world settings.
Authors: J Guintivano; P F Sullivan; A M Stuebe; T Penders; J Thorp; D R Rubinow; S Meltzer-Brody Journal: Psychol Med Date: 2017-09-27 Impact factor: 7.723
Authors: Joanne N Wood; Oludolapo Fakeye; Chris Feudtner; Valerie Mondestin; Russell Localio; David M Rubin Journal: Pediatrics Date: 2014-06-16 Impact factor: 7.124
Authors: M Katherine Henry; Joanne N Wood; Kristina B Metzger; Konny H Kim; Chris Feudtner; Mark R Zonfrillo Journal: J Pediatr Date: 2016-07-14 Impact factor: 4.406
Authors: Kristin Garton Crichton; Jennifer N Cooper; Peter C Minneci; Jonathan I Groner; Jonathan D Thackeray; Katherine J Deans Journal: Pediatr Surg Int Date: 2016-07-06 Impact factor: 1.827