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Several racial/ethnic disparities in health, health care reported among adolescents, data reveal

Saturday, April 07 2012 | Comments
Evidence Grade 0 What's This?
Multiple racial/ethnic disparities in health and health care exist among adolescents aged 10 to 17 years, new research shows.

The study investigators noted that adolescents in this age group represent nearly half of the pediatric population in the United States and approximately half are considered racial/ethnic minorities. 

Data for the analysis were obtained from the 2003 National Survey of Children's Health, a cross-sectional, random-digit-dial household telephone survey that was conducted by the National Center for Health Statistics. Overall, 48,742 completed interviews were analyzed for adolescents aged 10 to 17 years.

To identify disparities in 40 measures of health and health care, the researchers conducted bivariate and multivariable analyses for white, black, Latino, Asian/Pacific Islander, American Indian/Alaskan Native and multiracial adolescents. The measures were categorized into three domains: medical and oral health, access to care and use of health services.

The highest percentages of optimal health (excellent or very good) were reported among white (66.1 percent and 23.4 percent, respectively), Asian/Pacific Islander (65.2 percent and 22.2 percent) and multiracial (58.3 percent and 28.9 percent) adolescents.

Obesity and overweight status was observed in approximately 40 percent of American Indian/Alaskan Native, black and Latino adolescents. The highest proportions of asthma were reported among American Indian/Alaskan Native (20 percent), black (18.6 percent) and multiracial (16.8 percent) adolescents.

A greater percentage of parents of American Indian/Alaskan Native (19.2 percent), multiracial (15.5 percent) and white (13.4 percent) adolescents reported needing more medical care than did parents of children in other racial/ethnic groups (11.4 percent for Latino, 11.8 for black and 3.8 percent for Asian/Pacific Islander adolescents).

Latino (23.8 percent) and American Indian/Alaskan Native (13.4 percent) adolescents were significantly more likely to lack health insurance than were white children (6.4 percent). Latino (16 percent), American Indian/Alaskan Native (16 percent) and black (14.1 percent) youth had the highest proportion of sporadic insurance coverage.

Public insurance coverage was most prevalent among black (46 percent), American Indian/Alaskan Native (45.2 percent) and Latino (37.3 percent) adolescents.

The lowest percentages of adolescents who had a personal physician or nurse were in the Latino and American Indian/Alaskan Native communities. The American Indian/Alaskan Native group had the lowest proportion of subjects who received all needed medical care, but more than 90 percent of all of the groups received needed care. Multiracial (8.5 percent) and white (5.3 percent) adolescents had the highest rate of unmet medical needs due to the physician not knowing how to provide care; less than 2 percent of all the other groups had unmet needs for this reason. Experiencing problems getting specialty care was reported by approximately half of American Indian/Alaskan Native and Asian/Pacific Islander adolescents. In the past year, black adolescents had the highest prevalence of not receiving all needed prescription drugs.

Results from the multivariable analysis indicated that Latino and black adolescents were significantly more likely to have suboptimal health status relative to white adolescents. Meanwhile, American Indian/Alaskan Native, black and Latino subjects had greater odds of being overweight or obese and having asthma. American Indian/Alaskan Native adolescents also had higher odds of having hearing/vision problems, whereas black and Asian/Pacific Islander adolescents had lower odds.

Moreover, Asian/Pacific Islander individuals had lower odds of bone/joint/muscle problems and diabetes, while black individuals had lower odds of diabetes.

Access to care, according to the multivariable data, was better among white adolescents. Adolescents in American Indian/Alaskan Native, Latino and black communities had significantly greater odds than those in the white community to be uninsured or sporadically have insurance.

All minority racial/ethnic individuals except those who were Asian/Pacific Islander had higher odds than did white individuals of having no personal physician or nurse.

Asian/Pacific Islander subjects were more than 26 times as likely and multiracial subjects were more than eight times as likely to have an unmet medical care need due to a problem with their plans.

Black, Asian/Pacific Islander and American Indian/Alaskan Native, Latino adolescents had greater odds than white adolescents of having no physician visits in the past year.

Asian/Pacific Islander subjects had lower odds of having at least one emergency department visit in the past year as compared with white adolescents.

"These findings indicate a need for ongoing identification and monitoring of and interventions for disparities for all five major racial/ethnic groups and multiracial adolescents," the study authors remarked.

They noted that recent health care reform legislation has targeted "increasing the pediatric workforce, establishing quality-of-care priorities, enhancing preventive pediatric services to include oral and vision services, expanding Medicaid, increasing Medicaid payments to physicians and ensuring insurance security regardless of employment status."

"The study findings suggest that these measures could help reduce or eliminate many racial/ethnic disparities in the health and health care of adolescents," the team suggested.

The study findings were reported online March 14 ahead of print in the journal Health Services Research.

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