Recent data reveals that San Francisco refers Black and Latino families to Child Protective Services (CPS) custody at a higher rate than Caucasian families. In the city of San Francisco, there are 208 allegations of child maltreatment per 1,000 children—with many referrals originating at Zuckerberg San Francisco General (SFGH). SFGH is the largest safety-net hospital in the area and about 1,000 babies are born there every year. Currently, there is no protocol in place within the hospital to provide guidance to clinicians or social workers around involving CPS in a patient’s case. Furthermore, there is no mechanism for departmental oversight of referrals to CPS and many patients perceive bias and racism to be at play in their CPS referrals.
In October, estimated GFR (eGFR) reporting was modified by the laboratory at Zuckerberg San Francisco General Hospital. Whereas previously eGFR was reported as two separate values i.e. “if African American” or “if non African American,” these two values are now reported as a range with the clinical note: “Patients with more muscle mass and better nutritional status are more likely to be on the higher end of this range.” This change was made in an effort to reduce medical errors and improve health equity at our hospital and affiliated clinics.
When I was pregnant with my last son, I wasn’t technically homeless, but I wouldn’t go home because I didn’t want to be around my mom or my daughter who was 15 at the time and my other son who was 15 months, while I was on drugs. I got mad at my son’s father, and I wouldn’t go home, so I literally walked all the way to UCSF. I got out of the car, and my water broke. That’s when I started walking.