Racial/ethnic and socioeconomic disparities in the diagnosis and treatment of sleep-disordered breathing in children
Abstract
Objective Although racial/ethnic and socioeconomic healthcare disparities in pediatric primary care are widely documented, little is known regarding health disparities for common otolaryngic conditions. Pediatric sleep-disordered breathing (SDB) is highly prevalent, associated with significant physical and neurocognitive sequelae, and a common reason for pediatric otolaryngology referral. We sought to synthesize information from published findings related to racial/ethnic and socioeconomic disparities in children with SDB.Methods Qualitative systematic review of MEDLINE database for articles reporting on racial/ethnic or socioeconomic differences in prevalence, diagnosis or surgical treatment of SDB in children over 30 years.Results Of 210 abstracts identified, 33 met inclusion criteria. 24 articles directly addressed differences in race/ethnicity and socioeconomic status, and 10 had findings which identified a disparity. Differences were identified in prevalence, sleep patterns, and sequelae of pediatric SDB (24/33) and in access to care and utilization of adenotonsillectomy (10/33). Black children (12/33) and children with socioeconomic deprivation (17/33) were the most common minority groups studied. Although conclusions were broad, common study findings showed: (1) children in racial/ethnic and socioeconomic minorities may have higher prevalence and greater risk for SDB, and (2) In the U.S., white children or children with private insurance are more likely to undergo adenotonsillectomy.Conclusions Racial/ethnic and socioeconomic disparities are prevalent among children with SDB. Disparities in multiracial populations and disparities in access to care, treatment, and utilization of services for pediatric SDB require more detailed investigation. Given the potential negative impact of SDB in children, as well as its economic consequences, the evaluation of disparities should be prioritized in health policy research.
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Some studies have found that sleep quality is worse among racial/ethnic minorities, while others have not.
“Although some studies have found that sleep quality is worse among racial/ethnic minorities(229-232), others have not(233-235).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [230]
Some studies have found overall sleep quality to be worse among minorities.
“For example, some studies have found overall sleep quality to be worse among minorities (Boss et al., 2011; Kripke et al., 2004; Moore et al., 2011; Patel et al., 2010b)”
From Addressing sleep disturbances: an opportunity to prevent cardiometabolic disease? (2014) · cites this paper as Boss et al., 2011
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- Authors
- Boss, E. F., Smith, D. F., & Ishman, S. L.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Boss, Emily F.
- Venue
- International Journal of Pediatric Otorhinolaryngology
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 75
- Issue
- 3
- Pages
- 299-307
- ISSN
- 0165-5876 (ISSN-L)
- OpenAlex
- W2051883923
- Cited by
- 159
- References
- 59
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 15 · 2023: 21 · 2022: 18 · 2021: 17 · 2020: 14 · 2019: 4 · 2018: 6 · 2017: 6 · 2016: 11 · 2015: 8 · 2014: 4 · 2013: 9 · 2012: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Pediatric Otorhinolaryngology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep-disordered breathing, pediatric sleep apnea, racial and ethnic disparities, socioeconomic disparities, adenotonsillectomy, health care access, health care utilization, Black children, insurance status, otolaryngology referral
- MeSH terms
- Adenoidectomy, Child, Health Services Accessibility, Humans, Insurance, Health, Sleep Apnea Syndromes, Social Class, Tonsillectomy, Racial Groups
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