title: A source of healthcare disparity: race, skin color, and injuries after rape among adolescents and young adults.
abstract: Differences in anogenital injury resulting from rape may occur because of racial or skin color differences in adult women. It is critical to determine if these differences also are associated with differences in injury prevalence and frequency in adolescents and young adults. In a retrospective review of medical records, we examined whether Black adolescent/young adult females had different anogenital injuries as compared to White females following rape. Next, we examined whether skin color differences explained a significant amount of the racial difference in injuries. We reviewed charts of 234 female victims of rape ages 14 to 29. Overall injury prevalence was 62.8%. Race was significantly associated with frequency of injuries in several anatomical locations, with White victims having a higher frequency of injuries than Black victims. Skin color was significantly associated with injury frequency in many anatomical locations, with victims with light skin sustaining more injuries than victims with dark skin. Even when skin color was included in the relationship, race remained a statistically significant factor, suggesting that the relationship between race and injuries may be more complicated than merely a skin color difference that has been mislabeled a racial difference.
authors.affiliation: Cincinnati Children's Hospital Medical Center, and University of Cincinnati College of Nursing, Cincinnati, Ohio 45229, USA. rachel.baker@cchmc.org
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Baker
authors.forename: Jamison D
authors.initials: JD
authors.lastname: Fargo
authors.forename: Donna
authors.initials: D
authors.lastname: Shambley-Ebron
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Sommers
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000235:genetics / Q000706:statistics & numerical data; D001003:Anal Canal / Q000293:injuries; D015982:Bias; D005260:Female; D005554:Forensic Medicine / Q000379:methods*; D053604:Forensic Nursing; D005836:Genitalia, Female / Q000293:injuries; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D010781:Photography; D010808:Physical Examination; D015995:Prevalence; D011902:Rape / Q000175:diagnosis* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012880:Skin Pigmentation / Q000235:genetics*; D044465:White People / Q000235:genetics / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult