Background: Mothers of color are 10x more likely to be referred to child protective services (CPS) than white mothers. There is a lack of research on the role healthcare providers play in perpetuating this racial disproportionality. Two models have been proposed: the risk-based model, which assumes minority groups use more illicit substances than white people, and the bias-based model, which assumes healthcare providers are biased against minority groups and thus refer them to CPS more frequently. Objectives: To compare current literature on the risk model vs. bias model of CPS referrals from physicians, and to analyze DCYF referrals of pregnant women at Tri-County Community Action Agency (TCCAA). Methods: A quasi-systematic literature search of articles published after 1990 and referencing keywords “child services”, “healthcare providers” and “racial disproportionality” was performed; 30 articles were identified through PubMed and Google Scholar. Normative analysis identified reference to risk vs. bias-based models, in addition to predominant risk factors for CPS referral. A chart audit of pregnant patients at TCCAA referred to DCYF between 2017 and 2020 was performed (N=6), and demographic factors were compared to national data as it relates to substance abuse. Results: There was not a significant discrepancy in reference to risk vs. bias-based models. Patients of low SES, racial minority status and of single-parent households have an increased risk of CPS referral from providers. There was a significant lack of research relating to provider decision-making specific to pregnant women. All pregnant women referred to DCYF from TCCAA self-identified as white. Substance abuse was the primary reason for CPS referral in pregnant women; type of substance used varied from national data. Conclusions: More research needs to be done on providers’ referral of pregnant women to CPS. A larger study involving multiple clinics would provide more reliable data for study of risk/bias model use.
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Citation
Maner, Morgan,
"Demographics and DCYF: How We Rationalize Racial Disproportionality"
(2020).
Gateways to Medicine, Health Care, and Research.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/j8mv-sf46
The Gateways Program at the Warren Alpert Medical School of Brown University provides academically promising, motivated students new pathways to careers in the health sciences. This collection houses scholarly works produced by Master of Science in Medical Sciences (ScM) students …
