Published online June 2, 2008
PEDIATRICS Vol. 121 No. 6 June 2008, pp. 1174-1180 (doi:10.1542/peds.2007-1846)
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ARTICLE

Race Matters in the Prosecution of Perpetrators of Inflicted Traumatic Brain Injury

Heather T. Keenan, MDCM, PhDa, Maryalice Nocera, BSN, MSNb and Desmond K. Runyan, MD, DrPHc,d

a Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah
b Injury Prevention Research Center
Departments of c Social Medicine
d Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

OBJECTIVE. The goal was to examine the case flow of child physical abuse prosecutions through the judicial system and to examine determinants of charges and sentencing decisions.

METHODS. This prospective cohort study monitored all defendants in identified cases of inflicted traumatic brain injury in North Carolina in 2000 and 2001. Victims were identified prospectively through surveillance at all PICUs in North Carolina and the Office of the Chief Medical Examiner. Suspected perpetrators were identified through information from families, hospital records, newspaper clippings, the Department of Corrections, and Clerks of Superior Court. Judicial case flow from original charges through sentencing was mapped. The victims' injury characteristics and suspects' characteristics, including potential mitigating and aggravating factors, were examined. Suspected perpetrator and victim characteristics were entered into multivariate models for examination of associations with charges and sentencing decisions.

RESULTS. Original and final charges varied widely. The most frequent original and final charge was the lowest-class felony child abuse charge. The child's death was predictive of higher felony charges. Sentences ranged from probation to life in prison. Of the defendants who were found to be guilty, 63% were incarcerated for some period of time. Severe sentences were associated with perpetrator race.

CONCLUSIONS. Prosecutors frequently charged the lowest felony child abuse charge available unless the child died. Minority status was not important in the decision to bring charges against a suspect but was the most important measured factor in rendering a sentence. Although the most appropriate charges and sentences can be argued, there seems to be a statewide bias toward harsher sentences for minority perpetrators.

Key Words: child abuse • judicial decisions • disparity • race

Abbreviations: CI—confidence interval • DOC—Department of Corrections • RR—relative risk • TBI—traumatic brain injury • OR—odds ratio

Accepted Oct 11, 2007.


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