Study Highlights Racial Inequities in Foster Care Placement Following Non-Accidental Trauma

Black Children Are More Likely to be Victims of Non-Accidental Trauma and Discharged to Foster Care

August 05, 2024
Dr. Irim Salik and Sonali Dadoo
Irim Salik, M.D., and Sonali Dadoo

Non-accidental trauma (NAT) is a leading cause of traumatic death and disability in children, with many of these victims later placed in foster care. A new study conducted by New York Medical College faculty and students found that neighborhood disadvantage—marked by a lack of economic and social resources—is an independent predictor of discharge to foster care. The study, recently published in the Journal of Pediatric Surgery, also revealed that Black children were disproportionally overrepresented in both the NAT population they studied and among those placed in foster care.

“Previous studies evaluating race and NAT have shown similar results with Black children disproportionately overrepresented in both the NAT and foster care populations,” says Irim Salik, M.D., associate professor of anesthesiology and co-author of the study. “These findings are likely due to multiple factors. Systemic racism places Black families at higher risk for lower socioeconomic status, increased poverty, lower parental education, and higher family stress— all risk factors for abuse and family welfare involvement. Additionally, both conscious and unconscious bias within the health care system leads to increased screening and referral of Black children to Child Protective Services, resulting in higher foster care placements.” 

For the study, an eight-year retrospective chart review was conducted in pediatric patients at NYMC’s major clinical affiliate Maria Fareri Children’s Hospital in Valhalla, New York. Identified risk factors for NAT include young age (less than a year old), parental unemployment, single-parent households, rural settings, and low socioeconomic status. 

“Any information that sheds light on injury prevention in this patient population can profoundly improve healthcare in pediatric patients who are victims of NAT,” says Sonali Dadoo, SOM Class of 2025, who presented the study at the Ninth Annual Meeting of the Pediatric Trauma Society National Conference in November.