Lack of Insurance Raises Abused Babies' Death Risk

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The reasons for this association are unclear, Falcone said. "It's a complicated problem. Maybe these babies are less healthy, less able to respond to these unfortunate injuries. That may be related to lack of prenatal care, difficulty getting access to early childhood care because of lack of insurance or economic strains," he said.

It could also be due to differences in the quality of care delivered by doctors and hospitals, Falcone noted. "It is our responsibility to prove to ourselves and to the community that it's not the quality of care that they received after the injury that's different," he said. "We need to find out what all the problems are and how to address them.

Falcone noted that while many of the children without private health insurance were uninsured, some were covered by state or federal programs, such as SCHIP or Medicaid. However, whether or not they had state sponsored insurance before being admitted to the hospital is not known, he said.

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Dr. Carole Jenny, chair of the Committee on Child Abuse and Neglect at the American Academy of Pediatrics, and director of the Child Protection Program at Hasbro Children's Hospital in Providence, R.I., believes the study raises a key issue.

"This is an extremely important study," Jenny said. "The diagnosis of child abuse should be blinded to race, family composition or socioeconomic status," she said.

In a previous study, Jenny found that in abused children, serious head injuries were more likely to be missed by physicians if the child was white and from an intact family.

"This was essentially a reverse bias -- making the abuse of white children more likely to be overlooked, thus putting them at risk for further abuse," Jenny said.

More information

For more on child abuse, visit the U.S. National Library of Medicine.

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