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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: 49.6 million Americans speak a non-English primary language at home (NEPL), but little is known about health disparities for NEPL children.

Objective: To identify disparities for NEPL children in medical and oral health, access to care, and use of services.

Design/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 NEPL children compared to children with English as the primary language at home (EPL). Multivariate analyses were performed to adjust for race/ethnicity, age, insurance coverage, income, parental education and employment, and number of children and adults in the household.

Results: 13% of US children (equivalent to 9.2 million) live in NEPL households; NEPL children are significantly (P<.05) more likely than EPL children to be Latino (87%) or Asian/Pacific Islander (7%), poor (42 vs. 13%), and to have unemployed and non-high-school graduate parents. Significantly higher proportions of NEPL children are uninsured (27 vs. 6%), sporadically insured (20 vs. 10%), not in excellent/very good health (43 vs. 12%), overweight/at risk for overweight (48 vs. 39%), and have teeth in fair/poor condition (27 vs. 7%). NEPL children more often have no usual source of care (USC; 38 vs. 13%), made no medical (27 vs. 12%) or dental (14 vs. 6%) visits in the past year, and had problems getting specialty care (40 vs. 23%), but less often receive mental healthcare (4 vs. 7%) and are able to get help from USCs via phone (68 vs. 81%). NEPL children more often did not receive needed medical care due to cost (43 vs. 26%) or no insurance (59 vs. 39%) and did not receive needed dental care due to health plan problems (20 vs. 8%). Latino and Asian NEPL children had several unique disparities compared to white NEPL children. Almost all disparities persisted in multivariate analyses; for example, NEPL children were significantly more likely than EPL children to not be in excellent/very good health (OR=2.7 [95% CI, 2.3-3.1]), to have teeth in suboptimal condition (OR=1.9 [1.6, 2.1]), to have no USC (OR=1.7 [1.4-1.9]), and to have problems getting specialty care (OR=1.7 [1.2-2.3]).

Conclusions: Compared to EPL children, NEPL children experience multiple disparities in medical and oral health, access to care, and use of services.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to identify disparities for children in households where a non-English primary language is spoken at home in medical and oral health, access to care, and use of services.

Keywords: Culture, Minority Health

Presenting author's disclosure statement:

Any relevant financial relationships? No