Kotch J B, Chalmers D J, Fanslow J L, Marshall S, Langley J D
Department of Maternal and Child Health, University of North Carolina School of Public Health, Chapel Hill 27599-7400.
Child Abuse Negl. 1993 Mar-Apr;17(2):233-47. doi: 10.1016/0145-2134(93)90043-5.
The purpose of this study was to explore under-diagnosis and racial bias among child abuse morbidity and mortality data from New Zealand. Computerized files of all intentional injury fatalities among children 16 years of age and under for 1978-87, and all hospital discharges for intentionally injured children 16 and under for 1988, were analyzed for evidence of physical abuse and sexual abuse. Among the 92 fatalities, only 21 of 68 deaths due to physical and/or sexual abuse were so coded. In both the mortality and the morbidity data, there was an association between the diagnosis of child abuse and race. In the case of fatalities, Maori and Samoan abuse victims were more likely to be assigned an E-code of E967 ("child battering and other maltreatment") than were "others" (p = 0.04), controlling for sex. In the case of hospitalizations, the association between E967 and whether or not the victim was European was significant for physical abuse only (p = 0.05). Assignment of N-code = 995.5 ("child maltreatment syndrome") as the reason for admission was significantly associated with race for those cases considered by us to have been abused, controlling for age (p = 0.002) or sex (p = 0.004).
本研究旨在探究新西兰儿童虐待发病率和死亡率数据中的诊断不足及种族偏见情况。对1978 - 1987年16岁及以下儿童所有故意伤害致死的计算机化文件，以及1988年16岁及以下故意伤害儿童的所有医院出院记录进行分析，以寻找身体虐待和性虐待的证据。在92例死亡病例中，68例因身体和/或性虐待导致的死亡中只有21例被如此编码。在死亡率和发病率数据中，儿童虐待诊断与种族之间均存在关联。在死亡病例中，在控制性别因素后，毛利人和萨摩亚虐待受害者比“其他种族”更有可能被分配E编码E967（“儿童殴打及其他虐待”）（p = 0.04）。在住院病例中，仅在身体虐待方面，E967与受害者是否为欧洲人之间的关联具有显著性（p = 0.05）。在我们认为遭受虐待的病例中，将N编码 = 995.5（“儿童虐待综合征”）作为入院原因与种族显著相关，在控制年龄因素时（p = 0.002）或控制性别因素时（p = 0.004）均如此。
