Racial and ethnic disparities in early childhood health and health care
Racial and ethnic disparities in early childhood health and health care
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DOI：
10.1542/peds.2004-1474
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发表时间：
2005-02-01
期刊：
影响因子：
8
通讯作者：
Tomany-Korman, SC
中科院分区：
文献类型：
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作者：
Flores, G;Olson, L;Tomany-Korman, SC
背景。医疗保健方面的种族/民族差异最近引起了全国的广泛关注，但很少有研究关注儿童之间的差异。我们研究了幼儿健康和医疗保健方面的差异。方法。我们分析了 2000 年全国儿童早期健康调查（一项全国范围的家庭调查）中 2608 名 4 至 35 个月大的儿童的数据。总体答复率为65.6%。调查问题涉及健康、医疗保健以及与医疗保健提供者的互动。结果。西班牙裔和黑人儿童健康状况良好/非常好的可能性明显低于白人（分别为 72%、79% 和 90%），并且更有可能没有保险（分别为 31%、18% 和 9%）。只有 60% 的西班牙裔父母和 77% 的黑人父母会向其他人推荐孩子的医疗服务提供者，而白人父母的这一比例为 84%。少数族裔父母更常报告说，提供者从不或只是有时了解他们养育孩子的偏好，而西班牙裔父母最常报告说，提供者从不或只是有时了解他们孩子的需求。少数族裔家长更常被问到有关暴力、吸烟、饮酒和吸毒的问题。西班牙裔和黑人父母平均拨打医生办公室的电话次数明显少于白人（分别为 2.0、3.1 和 4.3）。医疗服务提供者将西班牙裔和黑人儿童转诊给专家的频率明显较低（分别为 11% 和 17%，而白人儿童为 22%）。大多数差异在多变量分析中仍然存在，并且在父母用西班牙语完成调查的儿童和父母用英语完成调查的儿童之间发现了一些差异。结论。年轻的少数族裔儿童在健康状况、保险覆盖范围、儿科就诊期间讨论的话题、父母感觉被提供者理解、父母满意度和专家转诊等方面存在多重差异。
Background. Racial/ethnic disparities in health care have received much national attention recently, but few studies have focused on disparities among children. We studied disparities in early childhood health and health care.Methods. We analyzed data for 2608 children, 4 to 35 months of age, from the 2000 National Survey of Early Childhood Health, a nationwide household survey. The overall response rate was 65.6%. Survey questions addressed health, health care, and interactions with health care providers.Results. Hispanic and black children were significantly less likely than whites to be in excellent/very good health (72%, 79%, and 90%, respectively) and were more likely to be uninsured (31%, 18%, and 9%, respectively). Only 60% of Hispanic and 77% of black parents would recommend their child's provider to others, compared with 84% of white parents. Minority parents more often reported that providers never or only sometimes understood their child-rearing preferences, and Hispanic parents most often reported that providers never or only sometimes understood their child's needs. Minority parents more often were asked about violence, smoking, drinking, and drug use. Hispanic and black parents averaged significantly fewer telephone calls to doctors' offices than did whites (2.0, 3.1, and 4.3 calls, respectively). Providers significantly less often referred Hispanic and black children to specialists (11% and 17%, respectively, compared with 22% for whites). Most disparities persisted in multivariate analyses, and several disparities were found between children with parents who completed surveys in Spanish and those with parents who completed surveys in English.Conclusion. Young minority children experience multiple disparities in health status, insurance coverage, topics discussed during pediatric visits, parents feeling understood by providers, parental satisfaction, and referrals to specialists.