Racial/Ethnic Disparities in the Health and Healthcare of US Adolescents: Has Anything Changed Over the Years?

Background: Little is known about racial/ethnic disparities in the health and healthcare of adolescents, and whether these disparities have changed over time.

Methods: The National Survey of Children's Health was a random-digit-dial phone survey conducted by the National Center for Health Statistics in 2003 and 2007 of nationally representative samples of households of children 0-17 years old. Disparities were examined for 40 measures of medical and oral health, access, and use of services for all youth 10-17 years old in both survey waves (n=94,729). Bivariable and multivariable analyses were used to identify disparities in African-American, Latino, Asian/Pacific Islander, Native American, and multiracial youth compared with white youth. Z-scores to were used to examine time trends from 2003 to 2007 (significance tested at α<.05).

Results: After adjusting for eight socioeconomic factors in multiple logistic regression analyses of the 2007 wave, disparities were noted for one or more racial/ethnic minority groups. For example, compared to white adolescents, minority adolescents were more likely to have the following: suboptimal medical and oral health, overweight/obesity, asthma, no health insurance, no personal doctor or nurse (PDN), insufficient time spent with the PDN, problems obtaining specialty care, and no specialty or mental health care in the past year. Compared with white youth in 2007, Latino, African-American, and multiracial youth had about double the odds of suboptimal medical and oral health, and Latinos, African-Americans, Native Americans, and multiracial youth had significantly greater odds of being uninsured and having no PDN. Certain disparities were especially prominent for specific racial/ethnic groups: for Latinos, having suboptimal medical health; for African-Americans, having suboptimal oral health, being overweight/obese, and having sporadic insurance; for Asian/Pacific Islanders, having no specialty and mental health care in the past year; and for Native Americans, having behavior problems, no medical insurance, no PDN, insufficient time spent with PDN, problems getting specialty care, and needing more medical care than others. Multiracial youth also had many disparities compared with white adolescents. Most racial/ethnic health and health care disparities persisted between 2003 to 2007, and two significantly worsened: problems obtaining specialty care in African-Americans, and ADHD in multiracial youth.

Conclusions: US adolescents experience many racial/ethnic disparities in medical and oral health, access, and use of services. Almost all disparities persisted over time, and some have worsened over time. Results from this study may prove useful in informing future research and policy on reducing adolescent racial/ethnic disparities in health and healthcare.