Not enough is known about the national prevalence of racial/ethnic disparities in
children's medical and dental care.
The purpose of this work was to examine racial/ethnic disparities in medical and oral
health, access to care, and use of services in a national sample.
The National Survey of Children's Health was a telephone survey in 2003-2004 of a
national random sample of parents and guardians of 102,353 children 0 to 17 years
old. Disparities in selected medical and oral health and health care measures were
examined for white, African American, Latino, Asian/Pacific Islander, Native American,
and multiracial children. Multivariate analyses were performed to adjust for primary
language at home, age, insurance coverage, income, parental education and employment,
and number of children and adults in the household. Forty measures of medical and
oral health status, access to care, and use of services were analyzed.
Many significant disparities were noted; for example, uninsurance rates were 6% for
whites, 21% for Latinos, 15% for Native Americans, 7% for African Americans, and 4%
for Asians or Pacific Islanders, and the proportions with a usual source of care were
as follows: whites, 90%; Native Americans, 61%; Latinos, 68%; African Americans, 77%;
and Asians or Pacific Islanders, 87%. Many disparities persisted for > or = 1 minority
group in multivariate analyses, including increased odds of suboptimal health status,
overweight, asthma, activity limitations, behavioral and speech problems, emotional
difficulties, uninsurance, suboptimal dental health, no usual source of care, unmet
medical and dental needs, transportation barriers to care, problems getting specialty
care, no medical or dental visit in the past year, emergency department visits, not
receiving mental health care, and not receiving prescription medications. Certain
disparities were particularly marked for specific racial/ethnic groups: for Latinos,
suboptimal health status and teeth condition, uninsurance, and problems getting specialty
care; for African Americans, asthma, behavior problems, skin allergies, speech problems,
and unmet prescription needs; for Native Americans, hearing or vision problems, no
usual source of care, emergency department visits, and unmet medical and dental needs;
and for Asians or Pacific Islanders, problems getting specialty care and not seeing
a doctor in the past year. Multiracial children also experienced many disparities.
CONCLUSIONS; Minority children experience multiple disparities in medical and oral
health, access to care, and use of services. Certain disparities are particularly
marked for specific racial/ethnic groups, and multiracial children experience many
disparities.