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APHA Scientific Session and Event Listing

Glenn Flores, MD, Sandra C. Tomany-Korman, and Emmanuel Ngui, DrPH, MSc. Department of Pediatrics, Medical College of Wisconsin, Center for the Advancement of Underserved Children, 8701 Watertown Plank Rd., Milwaukee, WI 53226, 414 456-4302, engui@mcw.edu

Background: Not enough is known about the national prevalence of racial/ethnic (R/E) disparities in children's medical and dental care.

Objective: To examine R/E disparities in medical and oral health and healthcare in a national sample.

Methods: The National Survey of Childhood Health was a phone survey in 2003-2004 of a national random sample of parents of 102,353 children 0-17 years old. Disparities in medical and oral health and healthcare were examined for non-Latino white (W), non-Latino African-American (AA), Latino (L), Asian/Pacific-Islander (API), Native American (NA), and multiracial (MR) 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.

Results: Many significant (P<.05) R/E disparities were noted; for example, uninsurance rates were 6% for Ws, 21% for Ls, 15% for NAs, 7% for AAs, and 4% for APIs, and the proportions with a usual source of care (USC) were: Ws, 90%; NAs, 61%; Ls, 68%, AAs, 77%; and APIs, 87%. The following disparities persisted for 1 or more minority groups in multivariate analyses: increased odds of suboptimal health status, overweight, asthma, activity limitations, behavioral/speech problems, emotional difficulties, suboptimal dental health, uninsurance, no medical or dental visit in the past year, ED visits, unmet medical and dental needs, transportation barriers to care, not receiving prescription medications, not receiving mental healthcare, no USC, USC communication problems, and problems getting specialty care. For example, compared with Ws, the ORs (95% CI) of having teeth in less than excellent condition were: APIs, 1.8 (1.3-1.6); AAs, 1.6 (1.4-1.7); Ls, 1.5 (1.4-1.7); and NAs, 1.4 (1.1-1.8). Certain disparities were particularly marked for specific R/E groups: for AAs, asthma, behavior problems, skin disorders, speech problems, and unmet prescription needs; for NAs, hearing/vision problems, ED visits, no USC, and unmet medical & dental needs; and for APIs, inferior oral health, not seeing a doctor in the past year, and problems getting specialty care. MRs 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 R/E groups, and MR children experience many disparities.

Learning Objectives: