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Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children

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Authors:
Summary:

Racial/ethnic disparities in children’s medical and dental care were examined for White, African American, Latino, Asian/Pacific Islander, Native American, and multiracial children, using data from the National Survey of Children’s Health – a US telephone survey in 2003–2004 of a national random sample of parents and guardians of 102,353 children 0 to 17 years old. Many significant disparities were noted, such as uninsurance rates (e.g. 6% for Whites vs 21% for Latinos) and the proportions with a usual source of care (e.g. Whites 90% vs Native Americans 61%). Many disparities persisted for ≥1 minority group in multivariate analyses (e.g. increased odds of suboptimal health status, overweight, asthma, emotional difficulties, unmet medical and dental needs, transportation barriers to care, problems getting specialty care, emergency department visits, not receiving mental health care, and not receiving prescription medications). Certain disparities were particularly marked for specific racial/ethnic groups, and multiracial children also experienced many disparities.

Comment:
A survey conducted in a large population in the US. There are two interesting things about this study. Firstly, it included dental care outcomes with health status questions. Secondly, the authors sought information about service provision and access through the care pathway for children from various ethnicities, and didn’t just describe differences in disease rates.
Reference: Pediatrics. 2008;121:e286-e298
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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