Health Disparities in the Forensic Sexual Assault Examination Related to Skin Color
Document Type
Article
Journal/Book Title/Conference
Journal of Forensic Nursing
Volume
5
Issue
4
Publisher
Wiley-Blackwell
Publication Date
2009
First Page
191
Last Page
200
Abstract
Little is known about the role of skin color in the forensic sexual assault examination. The purpose of this study was to determine whether anogenital injury prevalence and frequency vary by skin color in women after consensual sexual intercourse. The sample consisted of 120 healthy (63 Black, 57 White) women who underwent a forensic sexual assault examination following consensual sexual intercourse. Experienced sexual assault forensic examiners using visual inspection, colposcopy technique with digital imaging, and toluidine blue application documented the number, type, and location of anogenital injuries. Although 55% of the total sample was observed to have at least one anogenital injury of any type following consensual intercourse, the percentages significantly differed for White (68%) and Black (43%) participants (p= 0.02). When the presence of anogenital injury was analyzed by specific anatomical region, a significant difference between White and Black participants was only evident for the external genitalia (White = 56%, Black = 24%, p= .003), but not for the internal genitalia (White = 28%, Black = 19%, p= .20) or anus (White = 9%, Black = 10%, p= 0.99). A one standard deviation-unit increase in L* values (lightness) was related to a 150% to 250% increase in the odds of external genitalia injury prevalence (p < 0.001). While Black and White participants had a significantly different genital injury prevalence, dark skin color rather than race was a strong predictor for decreased injury prevalence. Sexual assault forensic examiners, therefore, may not be able to detect injury in women with dark skin as readily as women with light skin, leading to health disparities for women with dark skin.
Recommended Citation
Sommers MS, Fargo JD, Baker RB, Fisher BM, Buschur C, Zink TM. Skin color variation as a source of health disparity in the forensic sexual assault examination. Journal of Forensic Nursing. 2009;5:191-200.
Comments
Originally published by Wiley-Blackwell. Abstract available through remote link. Subscription required to access article fulltext.
Note: Jamison Fargo was affiliated with the University of Pennsylvania at time of publication. Copyright of this journal is held by the International Association of Forensic Nurses.