Preventable Injury Deaths: A Population-Based Proxy of Child Maltreatment Risk in California

Objective. This study used group variations in child injury fatality rates to assess racial bias in the population of children identified as victims of maltreatment. Methods. Injury fatality and maltreatment data from California were compiled for the years 1998–2007. Death and maltreatment risk ratios (RRs) and 95% confidence intervals (CIs) were computed by race and age. Rates of excess child injury mortality by race were derived from three different baseline rates of death. Substantiations per excess injury death were calculated. Results. Compared with white children, black children faced a risk of substantiated maltreatment that was more than twice as great (black RR: 2.39, 95% CI 2.37, 2.42) and were fatally injured at nearly twice the rate (black RR: 1.89, 95% CI 1.68, 2.12). Per excess death, however, black children had rates of substantiated maltreatment allegations that were equivalent to or lower than the rates for white children. Conclusions. These data support claims that, at least in California, black-white racial disparities observed in maltreatment rates reflect real group differences in risk. These data provide no evidence of systematic racial bias in the child protective services' substantiation process.