Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children.
Open accessAbstract
BACKGROUND. Not enough is known about the national prevalence of racial/ethnic disparities in children's medical and dental care. OBJECTIVE. The purpose of this work was to examine racial/ethnic disparities in medical and oral health, access to care, and use of services in a national sample. METHODS. The National Survey of Children's Health was a telephone survey in 2003–2004 of a national random sample of parents and guardians of 102353 children 0 to 17 years old. Disparities in selected medical and oral health and health care measures were examined for white, African American, Latino, Asian/Pacific Islander, Native American, and multiracial children. Multivariate analyses were performed to adjust for primary language at home, age, insurance coverage, income, parental education and employment, and number of children and adults in the household. Forty measures of medical and oral health status, access to care, and use of services were analyzed. RESULTS. Many significant disparities were noted; for example, uninsurance rates were 6% for whites, 21% for Latinos, 15% for Native Americans, 7% for African Americans, and 4% for Asians or Pacific Islanders, and the proportions with a usual source of care were as follows: whites, 90%; Native Americans, 61%; Latinos, 68%; African Americans, 77%; and Asians or Pacific Islanders, 87%. Many disparities persisted for ≥1 minority group in multivariate analyses, including increased odds of suboptimal health status, overweight, asthma, activity limitations, behavioral and speech problems, emotional difficulties, uninsurance, suboptimal dental health, no usual source of care, unmet medical and dental needs, transportation barriers to care, problems getting specialty care, no medical or dental visit in the past year, emergency department visits, not receiving mental health care, and not receiving prescription medications. Certain disparities were particularly marked for specific racial/ethnic groups: for Latinos, suboptimal health status and teeth condition, uninsurance, and problems getting specialty care; for African Americans, asthma, behavior problems, skin allergies, speech problems, and unmet prescription needs; for Native Americans, hearing or vision problems, no usual source of care, emergency department visits, and unmet medical and dental needs; and for Asians or Pacific Islanders, problems getting specialty care and not seeing a doctor in the past year. Multiracial children also experienced many disparities. CONCLUSIONS. Minority children experience multiple disparities in medical and oral health, access to care, and use of services. Certain disparities are particularly marked for specific racial/ethnic groups, and multiracial children experience many disparities.
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ASD is beginning to be identified more in lower-SES groups than previously; however, barriers to services still exist for lower-SES families of children with ASD (e.g., transportation, childcare, and job accommodations).
“ASD is beginning to be identified more in lower-SES groups than previously (7,11); however, barriers to services still exist for lower-SES families of children with ASD (e.g., transportation, childcare, and job accommodations) (18–26).”
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Self-citationDo race/ethnicity or socioeconomic status affect why we place ear tubes in children?
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Self-citation
- Authors
- Flores, G., & Tomany-Korman, S. C.
- Affiliations
- Children's Medical Center (US)
- Signature Science, LLC, Austin, Texas
- ORCID
- Flores, Glenn
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2008-02-01
- Volume
- 121
- Issue
- 2
- Pages
- e286-e298
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1992059896
- Cited by
- 492
- References
- 36
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 20 · 2023: 25 · 2022: 22 · 2021: 28 · 2020: 32 · 2019: 27 · 2018: 29 · 2017: 32 · 2016: 25 · 2015: 24 · 2014: 30 · 2013: 31 · 2012: 31
- FWCI
- 41.51
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- University Libraries (University of Maryland) (submittedVersion)
- Digital Repository at the University of Maryland (University of Maryland College Park)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- racial and ethnic disparities, child health, oral health, dental care, health care access, health care utilization, uninsurance, usual source of care, unmet medical needs, unmet dental care needs, Latino children, African American children, Native American children, multiracial children, asthma, emergency department visits, transportation barriers
- MeSH terms
- Adolescent, Child, Child, Preschool, Dental Care, Ethnicity, Female, Health Services, Health Services Accessibility, Health Surveys, Humans, Infant, Male, Socioeconomic Factors, United States, Multivariate Analysis, Health Care Surveys, Racial Groups, Health Status Disparities, Healthcare Disparities
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