Bias and Objectivity When Evaluating Social Risk Factors for Physical Abuse: of Babies and Bathwater

Social factors are clearly important in the risk of child physical abuse. If abuse commonly occurs when parenting demands overwhelm emotional resources, it makes sense that young or single parenthood, poverty, substance use, and criminal justice involvement are associated with abuse.1,2 However, clinicians are currently ill-equipped to make sound use of social factors in the real world. Without accurate, objective data, clinicians often use their intuition to estimate social risk.3 In the US, where race continues to be associated to a shameful degree with social risk factors, this can result in overtesting for African-American families and greater rates of missed abuse in others.

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