Racial/Ethnic Disparities in Health and Health Care among US Adolescents

Children's Medical Center Dallas, Dallas, TX.
Health Services Research (Impact Factor: 2.78). 03/2012; 47(5):2031-59. DOI: 10.1111/j.1475-6773.2012.01394.x
Source: PubMed


To examine racial/ethnic disparities in medical and oral health status, access to care, and use of services in U.S. adolescents.
Secondary data analysis of the 2003 National Survey of Children's Health. The survey focus was children 0-17 years old.
Bivariate and multivariable analyses were conducted for white, African American, Latino, Asian/Pacific Islander, American Indian/Alaskan Native, and multiracial adolescents 10-17 years old (n = 48,742) to identify disparities in 40 measures of health and health care.
Certain disparities were especially marked for specific racial/ethnic groups and multiracial youth. These disparities included suboptimal health status and lack of a personal doctor or nurse for Latinos; suboptimal oral health and not receiving all needed medications in the past year for African Americans; no physician visit or mental health care in the past year for Asian/Pacific Islanders; overweight/obesity, uninsurance, problems getting specialty care, and no routine preventive visit in the past year for American Indian/Alaska Natives; and not receiving all needed dental care in multiracial youth.
U.S. adolescents experience many racial/ethnic disparities in health and health care. 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.

Download full-text


Available from: Glenn Flores
  • Source
    • "For a long time, researchers on health disparities have realized that parental factors are associated with adolescent BMI, and have tried to understand the relative importance of specific factors in these associations (Lau et al., 2012; Gittelsohn & Rowan, 2011; Dietz & Gortmaker, 2001; Braveman, 2009; Holm, Vogeltanz-Holm, Poltavski, & McDonald, 2010; King, Smith, & Gracey, 2009 ). Interventions aimed at preventing weight gain have also recognized the importance of including parents in their efforts (Arcan et al., 2013; Caballero et al., 2003; Karanja et al., 2012; Karanja et al., 2010; Stone et al., 2003 ). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Obesity rates for American Indian and Alaska Native (AI/AN) adolescents are among the highest in the US. However, little is known about the influence of maternal correlates on adolescent body mass index (BMI), and the extent to which the size and significance of these correlates vary by adolescent sex and race. Methods: We conducted a cross-sectional analysis with a sample of 531 AI/AN and 8896 White mother/adolescent pairs from Wave 1 of the National Longitudinal Study of Adolescent to Adult Health. We used generalized estimating equations to measure the association of maternal educational attainment, marital status, employment status, obesity status, and adolescent BMI of AI/AN and White adolescents, while controlling for adolescents' demographic and behavioral covariates. We sought to determine whether the size and statistical significance of maternal correlates differed by race, and between mother/son and mother/daughter pairs. Results: The strength and statistical significance of maternal correlates varied between mother/son and mother/daughter pairs in both races. However, we did not find effect modification by race. Maternal obesity showed the strongest effect on adolescent BMI in all mother/adolescent pairs. Conclusion: Our findings suggest that maternal factors are critical in the transmission of obesogenic behaviors from one generation to the next, and their effects vary between mother/son and mother/daughter pairs, and are similar for AI/ANs and Whites. We encourage future work aimed at preventing adolescent obesity to investigate causal pathways between maternal correlates and adolescent BMI.
    Full-text · Article · Nov 2015 · Eating behaviors
  • [Show abstract] [Hide abstract]
    ABSTRACT: Since its inception in 1978, Pakistan's Expanded Programme on Immunization (EPI) has contributed significantly towards child health and survival in Pakistan. However, the WHO-estimated immunization coverage of 88% for 3 doses of Diptheria-Tetanus-Pertussis vaccine in Pakistan is likely an over-estimate. Many goals, such as polio, measles and neonatal tetanus elimination have not been met. Pakistan reported more cases of poliomyelits in 2011 than any other country globally, threatening the Global Polio Eradication Initiative. Although the number of polio cases decreased to 58 in 2012 through better organized supplementary immunization campaigns, country-wide measles outbreaks with over 15,000 cases and several hundred deaths in 2012-13 underscore sub-optimal EPI performance in delivering routine immunizations. There are striking inequities in immunization coverage between different parts of the country. Barriers to universal immunization coverage include programmatic dysfunction at lower tiers of the program, socioeconomic inequities in access to services, low population demand, poor security, and social resistance to vaccines among population sub-groups. Recent conflicts and large-scale natural disasters have severely stressed the already constrained resources of the national EPI. Immunization programs remain low priority for provincial and many district governments in the country. The recent decision to devolve the national health ministry to the provinces has had immediate adverse consequences. Mitigation strategies aimed at rapidly improving routine immunization coverage should include improving the infrastructure and management capacity for vaccine delivery at district levels and increasing the demand for vaccines at the population level. Accurate vaccine coverage estimates at district/sub-district level and local accountability of district government officials are critical to improving performance and eradicating polio in Pakistan.
    No preview · Article · May 2013 · Vaccine
  • [Show abstract] [Hide abstract]
    ABSTRACT: Unlabelled: To estimate the association between self-perceived oral health indicators and ethnic origin in Colombia, a cross-sectional study (Information from the 2007 National Public Health Survey) was conducted. Variables: belonging to an ethnic group (Exposure); oral health indicators (Outcomes); sex, age, education and self-rated health (control). Analyses were carried out separately for men (M) and women (W). The association between the exposure variable and the outcomes was estimated by means of adjusted odds ratio (OR) with confidence intervals (95% CI) using logistic regression. Men were more likely to report gum bleeding (aOR 1.78; 95% CI 1.44-2.23) and dental caries (aOR 1.69; 95% CI 1.42-2.02), while women were more likely to report unmet dental needs (aOR 1.43; 95% CI 1.27-1.49) and dental caries (aOR 1.34; 95% CI 1.22-1.47). Indigenous and Palenquero were more likely to report most of the indicators analyzed. Minority ethnic groups in Colombia were at risk to report oral health problems.
    No preview · Article · May 2013 · Journal of Immigrant and Minority Health
Show more