Destiny Tolliver, MD National Clinician Scholars Program Yale University School of Medicine New Haven, CT 06510-8088

Black Children Are Physically Restrained in Emergency Room at Disproportionate Rates Compared to White children Interview with:

Destiny Tolliver, MD National Clinician Scholars Program Yale University School of Medicine New Haven, CT 06510-8088

Dr. Tolliver

Destiny Tolliver, MD
National Clinician Scholars Program
Yale University School of Medicine
New Haven, CT 06510-8088

Katherine Nash MD, MHS
Assistant Professor of Pediatrics
Columbia University Irving Medical Center What is the background for this study?

Response: This study was motivated by work from our colleagues in the adult Emergency Medicine world. Earlier this year Dr. Ambrose Wong and colleagues published work describing racial disparities in the physical restraint of adults in the ED. This prompted our group to consider whether these disparities were also present for children. What are the main findings?

Response: We looked at a data from pediatric ED visits across a single large health system and found that even when controlling for a multitude of factors, Black children are being physically restrained at disproportionate rates compared to White children. We also found that males and those who are publicly insured are more likely to be restrained. What should readers take away from your report?

Response: Physical restraint is a last resort intervention used very rarely for children with neuropsychiatric disorders in acute crisis who might be a danger to themselves or others. Although we take significant precautions to ensure that the restraint is safe, any lay person can likely understand why provider to understand how physical restraint might be a traumatic experience for a child.

We found that Black children have an 80% higher odds of being physically restrained, which means that this traumatic experience is disproportionately experienced by Black children. What recommendations do you have for future research as a result of this work?

Response: Future studies should focus on what interventions work to reduce these disparities, both within hospitals and outside of them, within communities. Additionally, we know that approaches to behavior in other settings follow gendered patterns, and future studies should consider how intersectionality relates to these findings, since we know Black boys, girls, and gender non-conforming children experience discrimination differently. Is there anything else you would like to add?

Response: We believe that our findings represent the result of racism acting at interpersonal, institutional, and structural levels. It’s important for us as researchers and clinicians to acknowledge these data as a call to action for us to improve how we care for and support children in our communities.

I have no financial disclosures or conflicts of interest to report.


Nash KA, Tolliver DG, Taylor RA, et al. Racial and Ethnic Disparities in Physical Restraint Use for Pediatric Patients in the Emergency Department. JAMA Pediatr. Published online September 13, 2021. doi:10.1001/jamapediatrics.2021.3348



The information on is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.


Last Updated on September 17, 2021 by Marie Benz MD FAAD