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October 18, 2021

Racial Disparities in Child Abuse Medicine

Author Affiliations
  • 1Department of Pediatrics, University of Florida, Gainesville
  • 2Child Protection Team, University of Florida, Gainesville
  • 3Office for Diversity, University of Florida, Gainesville
  • 4Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville
JAMA Pediatr. Published online October 18, 2021. doi:10.1001/jamapediatrics.2021.3601

A child’s race does not change their risk for abuse, but the available, albeit scant and old, data from US child welfare systems tell a skewed story. While recent literature on racial disparities and systemic racism has documented how racism deeply affects children and families, little attention has been given to the most marginalized population in pediatrics: children who have been abused or neglected. Further, although racial and ethnic disproportionality and disparities in the child welfare system have been acknowledged,1 existing efforts and strategies to mitigate these differences have been small, occurring mostly at a single institution or rarely at a state level. Disparities in the outcomes of child welfare placements are the cumulative results of a series of upstream decisions, most often by pediatricians and other health care and child welfare professionals. The largest disparity by race is usually at the system’s front door, that is, when children are first reported to child protective services for neglect or abuse at the clinical point of contact when child abuse is first considered, suspected, or acknowledged. As we emerge from the COVID-19 pandemic, which has exacerbated racial and ethnic disparities and has set the stage for increased child abuse, we, as pediatricians, must use the momentum to address structural racism and finally confront disproportionalities and disparities in child abuse.

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