RESUMO
PURPOSE: Traumatic brain injury (TBI) is a leading cause of pediatric death and disability. Abusive head trauma confers greater morbidity and mortality compared with accidental TBI. National trends reveal disproportionate involvement of minority children in the child welfare system. The study investigates socioeconomic disparities in child protective services (CPS) involvement in pediatric TBI. METHODS: Retrospective chart review was conducted for TBI patients (n = 596) admitted to an academic pediatric level I trauma center from 2015 to 2022, where institutional policy dictates automatic CPS referral for TBI patients ≤ 2 years. Analysis of variance, chi-squared, and logistic regressions compared racial and ethnic groups and calculated adjusted odds of CPS case acceptance. RESULTS: Rates of non-accidental trauma, CPS involvement, insurance, and marital status differed across racial and ethnic backgrounds (p < 0.05). Of patients ≤ 2 years, Hispanic patients (OR: 0.38, 95%CI [0.16,0.91]) had decreased odds of CPS involvement compared to non-Hispanic White patients when adjusting for confounders including injury severity, injury type, and socioeconomic status. CONCLUSIONS: We highlight racial and ethnic differences in incidence of pediatric TBI and CPS involvement, even in the setting of an automatic CPS referral policy for pediatric TBI patients ≤ 2 years.
Assuntos
Lesões Encefálicas Traumáticas , Serviços de Proteção Infantil , Disparidades em Assistência à Saúde , Humanos , Lesões Encefálicas Traumáticas/etnologia , Lesões Encefálicas Traumáticas/epidemiologia , Estudos Retrospectivos , Masculino , Feminino , Lactente , Pré-Escolar , Disparidades em Assistência à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Serviços de Proteção Infantil/estatística & dados numéricos , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/etnologia , Fatores Socioeconômicos , Adolescente , Etnicidade/estatística & dados numéricosRESUMO
Sexual violence against children is a gross violation of children's rights during their formative years and will likely interfere with their developmental trajectory and long-term quality of life. As a result, this form of violence includes commercial sexual exploitation of children, sexual abuse, child marriages, and female genital mutilation. The evidence shows that violence prevention is worth the investment; however, prioritizing this agenda to ensure funding through government spending remains low. Despite funding realities, research and advocacy efforts need to continue, with a focus on promoting effective practices for mitigation.