Glenn Flores, MD¹, Sandra C. Tomany, MS¹, and Lynn Olson, PhD². (1) Center for the Advancement of Urban Children, Medical College of Wisconsin/Children's Hospital of Wisconsin, 8701 Watertown Plank Road, Milwaukee, AB 53226, 414-456-4193, stomany@mail.mcw.edu, (2) American Academy of Pediatrics, Department of Practice and Research, 141 Northwest Point Blvd, Elk Grove Village, IN 60007

Background: Racial/ethnic disparities in healthcare recently have received much national attention, but few studies have focused on disparities in children. We studied disparities in early childhood health and healthcare. Methods: We analyzed data on 2,608 children aged 4 to 35 months from the 2000 National Survey of Early Childhood Health, a nationwide household survey. The overall response rate was 65.6%. Survey questions addressed health, healthcare, and interactions with healthcare providers. Results: Hispanic and black children were significantly less likely than whites to be in excellent/very good health (72% vs. 79% vs. 90%), but more likely to be uninsured (31% vs. 18% vs. 9%). Only 60% of Hispanic and 77% of black parents would recommend their child s provider to others, vs. 84% of white parents (P<0.001). Minority parents more often reported providers never or only sometimes understand their childrearing preferences, and Hispanic parents most often reported providers never/only sometimes understand their child’s needs. Minority parents more often were asked about violence, smoking, drinking and drug use. Hispanic and black parents averaged fewer phone calls to doctors’ offices than whites (4.3 vs. 3.1 vs. 2.0, P<0.001). Providers less often referred Hispanic and black children to specialists (11% vs. 17% vs. 22% in whites; P<0.001). Most disparities persisted in multivariate analyses, and several disparities were found for children of parents completing surveys in Spanish. Conclusions: Young minority children experience multiple disparities in health, insurance coverage, the content of pediatric visits, parents feeling understood by providers, parental satisfaction, and referrals to specialists. Children whose parents complete surveys in Spanish also experience multiple disparities in health and healthcare. Greater insight is needed about why such disparities exist, and targeted educational interventions might help to ensure equal treatment for all children in their pediatric visits.

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