Minority and multiracial children experience many disparities in medical and oral health status, access to care, and use of services, according to a new national study by researchers at the Center for Advancement of Underserved Children at the Medical College of Wisconsin in Milwaukee and Children's Hospital of Wisconsin.

Their abstract will be presented at the 2006 Pediatric Academic Societies' annual meeting in San Francisco, April 30, by principal investigator Glenn Flores, M.D., associate professor of pediatrics, and director of the Center.

They also found that certain disparities were particularly pronounced among specific racial/ethnic groups. For example, when the researchers looked at oral health, the rates of minority children, compared to white children, having teeth in less than excellent condition were 80 percent higher for Asian Pacific Islanders, 60 percent higher for African Americans, 50 percent higher for Latinos and 40 percent higher for Native Americans.

The comparative rates of children without health insurance were six percent among whites, 21 percent among Latinos, 15 percent among Native Americans, seven percent among African Americans, and four percent among Asian Pacific Islanders.

The rates for having a usual source of health care were: 90 percent for whites; 61 percent for Native Americans; 68 percent for Latinos, 77 percent for African Americans, and 87 percent for Asian Pacific Islanders.

The team studied data from the National Survey of Childhood Health, a 2003-04 phone survey of a national random sample of parents of 102,353 children, 0-17 years old, according to Dr. Flores.

After adjustment in multivariate analysis, disparities in health status persisted for one or more minority groups in terms of suboptimal health or dental status, overweight, asthma, activity limitations and behavioral/speech or emotional problems. There were also disparities in care, such as the likelihood of medical or dental visits in the past year, emergency department (ED) visits, and unmet medical and dental needs. Discrepancies in access to care included transportation barriers, not receiving prescription medications, not receiving mental healthcare, communication problems with their usual source of care, and problems getting specialty care.

These racial/ethnic groups had pronounced adverse disparities in several areas:

-- African Americans: disparities were greatest in care for asthma, behavioral problems, skin disorders, speech problems, and unmet prescription needs

-- Latinos: disparities were greatest in the lack of health insurance, having no usual source of medical care, and not getting prescriptions for needed medications

-- Native Americans: disparities greatest in hearing/vision problems, frequent ED visits, no usual source of care and unmet medical dental needs.

-- Asian Pacific Islanders: disparities greatest in inferior oral health, not seeing a doctor in the past year, and problems getting specialty care.

-- Multiracial children also experienced multiple disparities, including significantly higher risks than white children of asthma, unmet healthcare needs due to health plan problems, having no regular healthcare provider, and having no dental visits in the past year.

Sandy Thomany-Korman, M.S., a statistician at the Center for the Advancement of Underserved Children at the Medical College department of pediatrics, coauthored the study.

Eileen LaSusa
lasusamcw.edu
Medical College of Wisconsin
mcw.edu