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Using Science To Enhance Equity

Findings and Implications From a Study To Detect Bruising on Victims With Dark Skin
Date Published
August 21, 2023

One way we can use science to enhance equity in the justice system is through research that informs better ways to detect and document bruising on victims with dark skin pigmentation.

The final plenary of the National Institute of Justice’s (NIJ) 2023 National Research Conference focused on this important topic. The plenary featured Dr. Katherine Scafide’s research on the use of alternate light sources on various skin tones, which successfully identified the best wavelengths of light to detect bruising in highly pigmented individuals. Her work exemplifies how innovation in scientific research can promote greater equity, and it advances the NIJ’s goals in this area.

NIJ 2023 Research Conference plenary "Can Science Enhance Equity? Findings and Implications From a Study To Detect Bruising on Victims with Dark Skin Pigmentation" participants Carrie Johnson, Dr. Katherine Scafide, Kimberly Foxx, and Chantel Hammond
Left to right:
Carrie Johnson, National Public Radio’s Justice Correspondent (facilitator)

​​​​Katherine Scafide, Associate Professor at George Mason University

Kimberly Foxx, Cook County (Illinois) State’s Attorney

Chantel Hammond, Forensic Nurse Specialist, International Association of Forensic Nurses

(Not pictured) Janine Zweig, Executive Science Advisor, National Institute of Justice (introduction) (View larger image.) (View larger image.)

The Intersection Between Science, Justice, and Racial Equity

The discussion invited the researcher, practitioner, and victim advocate perspectives to highlight ways that science could support victims of violence and enhance equity in interactions with the criminal justice system.

NIJ’s Janine Zweig, an expert on intimate partner violence and victimization, focused the discussion on medical forensic evidence collection.

“It’s a critically important topic,” Zweig noted, “and one of Director La Vigne’s major priorities in her agenda is applying a racial equity lens to our work.”

NPR’s Carrie Johnson facilitated the panel, referring to her recent interview with Scafide, which featured Scafide’s NIJ-funded research, and an NIJ podcast highlighting Scafide’s work. Johnson emphasized the impact and reach of Scafide’s research on marginalized and underrepresented communities, noting that earlier this year a judge in Georgia cited Scafide’s research results from the bench.

Barriers to Justice

Scafide was inspired by the frustration she felt as a forensic nurse when she was unable to detect or document an injury on a darker-skinned patient who had been a victim of violence. She noted that evidence of injury holds value in telling the story of those who have been victimized.

“It’s our responsibility as clinicians to capture that story through the documentation and the assessments that we do,” she said.

Kimberly Foxx, who is the first Black female State’s Attorney in Cook County, Illinois, highlighted that some people won’t report their assault because of legitimacy and credibility barriers. She explained that women of color are reluctant to engage with the system because law enforcement has systemically dismissed them. This has resulted in inadequate evidence gathering for this population. She thinks that the narrative can change with more equitable evidence gathering.

“In court,” said Foxx, “the most powerful evidence is forensic evidence.”

Inclusivity: Unique Research Design

According to Chantal Hammond, a practicing forensic nurse, the first interaction between a medical professional and trauma patient is critically important.

She called for experts to train forensic nurses to assess sexual assault cases more deeply than simply recording a history of assault. Hammond also stressed that nurses must be trained to recognize that injuries do not present the same way across all skin tones.

Like many other research techniques, lighter skinned researchers developed traditional methods of trauma assessment for lighter skinned people. These do not work as effectively for darker skinned individuals. Moving forward, the panel agreed that both research and practice must be approached with a racial equity lens.

Hammond noted that we need to design experiments to address race, not just add race into our experiments as a factor.

Scafide said she realized that technology could help her further the field, so she experimented with a variety of alternate light sources on diverse skin colors in a carefully controlled study. Ultimately, she wanted to ensure that forensic examiners could implement her evidence-based method in the field.

Her research is helping investigators and prosecutors pursue some assault cases that would not have been able to proceed in the past, due to a lack of evidence of injury.

Overcoming Courtroom Skepticism of Science

Many investigative techniques have been under the microscope since a 2009 study by the National Research Council that criticized some of the deficits in forensic science. In addition, numerous practitioners are calling for researchers to address issues of equity during the development of new techniques rather than after the fact.

According to Foxx, law enforcement must evolve constantly because scientific best practices change so rapidly. However, law enforcement tends to be on the back end of those changes because it takes researchers time to publish their work in peer-reviewed journals. Foxx said that she had seen disparity in the proportion of wrongful convictions against Black versus white defendants in her county. To her, the numbers don’t add up.

Foxx notes that there is a push for law enforcement to recognize their deeply problematic history with race. Now, more people are at the table — activists, advocates, researchers, and academics — and they are engaging in more conversations about being data- and research-driven.

“These conversations, particularly about racial equity, are very uncomfortable for a lot of people,” she said, “but to run away from the existence of racial disparities will only keep us further from the tools and the technology that will allow us to have the system that we aspire to, which is justice for all.”

Communicate Results, Improve Practice

Research like Scafide’s can be a game changer for many. But how does knowledge about new uses for technology spread?

Researchers and funding agencies such as NIJ must translate the results of evaluations of new technologies for the public, law enforcement, and courts to use.

Scafide will present clinical practice guidelines for implementing her technique at the International Association of Forensic Nurses meeting this September. There, she will speak about how to take her results to scale and how to overcome barriers to implementation. She hopes to educate practitioners, law enforcement, prosecutors, and judges about the benefits and limitations of her technique.

Hammond explained that sometimes practitioners don’t adopt the use of overly complicated equipment or techniques because of a lack of training.

According to Hammond, “Equipment is only as good as the practitioner who uses it. We must be able to pair that practitioner with that equipment and make sure that the practitioner is ready to use it and understand it, but also understand, if I don’t have this equipment, then what do I do?”

Alternate light sources are expensive, which creates a question of access. For forensic units, investment in making the technology more affordable and more accessible will be vital to progress, especially in rural communities and those where funding is scarce.

To produce change, Hammond called for equity in new hires in the field of forensic nursing — not just at the ground level, but also in leadership. Foxx agreed, saying that institutional bravery is critical for real change to occur.

“This is about a system that has really been entrenched with science that has not been inclusive of everyone, that has not been interrogated for outcomes that are vastly different,” said Foxx. “There is a responsibility of the people who wield power to do something about it, or you will just continue to perpetuate a system that you know is flawed.”

Date Published: August 21, 2023