Health Inequity in Children and Youth With Chronic Health Conditions
Health Inequity in Children and Youth With Chronic Health Conditions
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DOI：
10.1542/peds.2010-1466d
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发表时间：
2010-12-01
期刊：
影响因子：
8
通讯作者：
Palfrey, Judith S.
中科院分区：
文献类型：
--
作者：
Berry, Jay G.;Bloom, Sheila;Palfrey, Judith S.
背景：在过去的几十年里，慢性病儿童的医疗保健取得了巨大进步，但并非所有儿童都能平等地从中受益。 目标：描述慢性病儿童所经历的健康不平等。 方法：我们对 1985 年 1 月至 2009 年 5 月期间发表的 Medline、疾病控制与预防中心、国家癌症研究所和囊性纤维化基金会网站上确定的英文研究进行了文献综述，包括 20 岁以下的儿童0至18岁，并在以下健康状况的标题或摘要中包含关键词“发病率”、“患病率”、“生存率”、“死亡率”或“差异”：急性白血病、哮喘、注意力缺陷/多动障碍（ADHD）、自闭症谱系障碍、脑瘫、囊性纤维化、糖尿病、唐氏综合症、艾滋病毒/艾滋病、严重先天性心脏缺陷、重度抑郁症结果：黑人儿童脑瘫和艾滋病毒/艾滋病的发病率较高，被诊断为多动症的可能性较小，急诊就诊、住院的次数较多，与哮喘相关的死亡率较高；与白人儿童相比，患有唐氏综合症、1 型糖尿病和脑外伤的儿童存活率较低。与白人儿童相比，墨西哥出生的母亲患脊柱裂的西班牙裔儿童比例较高，艾滋病毒/艾滋病和抑郁症的比例较高，被诊断出注意力缺陷多动症的可能性较小，1型糖尿病的血糖控制较差，患急性白血病的存活率较低。结论：对于患有慢性疾病的儿童来说，严重的种族和民族健康和医疗保健不平等现象依然存在。儿科2010; 126：S111-S119
BACKGROUND: Over the last decades, there have been great advances in health care delivered to children with chronic conditions, but not all children have benefitted equally from them.OBJECTIVES: To describe health inequities experienced by children with chronic health conditions.METHODS: We performed a literature review of English-language studies identified from the Medline, Centers for Disease Control and Prevention, National Cancer Institute, and Cystic Fibrosis Foundation Web sites that were published between January 1985 and May 2009, included children aged 0 to 18 years, and contained the key words "incidence," "prevalence," "survival," "mortality," or "disparity" in the title or abstract for the following health conditions: acute leukemia, asthma, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders, cerebral palsy, cystic fibrosis, diabetes mellitus, Down syndrome, HIV/AIDS, major congenital heart defects, major depressive disorder, sickle cell anemia, spina bifida, and traumatic brain injury.RESULTS: Black children had higher rates of cerebral palsy and HIV/AIDS, were less likely to be diagnosed with ADHD, had more emergency department visits, hospitalizations, and had higher mortality rates associated with asthma; and survived less often with Down syndrome, type 1 diabetes, and traumatic brain injury when compared with white children. Hispanic children had higher rates of spina bifida from Mexico-born mothers, had higher rates of HIV/AIDS and depression, were less likely to be diagnosed with ADHD, had poorer glycemic control with type 1 diabetes, and survived less often with acute leukemia compared with white children.CONCLUSIONS: Serious racial and ethnic health and health care inequities persist for children with chronic health conditions. Pediatrics 2010; 126: S111-S119