Health disparity gap widening for minority children

Minority children have higher mortality rates, less access to physicians and fewer immunizations than do white children, according to a report in the April Pediatrics.

Researchers analyzed 111 studies published between 1950 and the first week of March 2007 that examined racial/ethnic disparities for U.S. children up to age 18. The review found gaps in health care persisted or worsened for the nation's four major minority groups identified for the study: African-Americans, American Indians/Alaska Natives, Asians/Pacific Islanders and Latinos.

Latino children with acute lymphoblastic leukemia had higher adjusted risks of death than their white counterparts, according to the report conducted by the American Academy of Pediatrics' Committee on Pediatric Research (link).

Asthma prevalence and incidence of HIV/AIDS were highest among African-American children. Pacific Islander children with cancer had significantly greater odds of death and untimely treatment than did whites.

"These statistics are just heart-breaking," said Willarda V. Edwards, MD, president of the National Medical Assn. and an internist in Baltimore. "It's incumbent upon all health professionals to recognize the disparity in the minority community and hopefully ... we will save this generation."

About 31.4 million, or 43%, of the nation's children are minorities, according to the report. Latinos, followed by African-Americans, represent the largest and fastest growing of these groups.

Addressing disparities is essential as the nation's minority population continues to grow, the report's authors said. By 2040, minorities are expected to make up half of the country's youth.

"This should be one of the major public health issues of this decade. When you see children dying at a higher rate just because of their race and ethnicity, that's really concerning," said study lead author Glenn Flores, MD, a pediatrician at Children's Medical Center of Dallas. He also is a member of the AAP's Committee on Pediatric Research, and professor of pediatrics and director of the division of general pediatrics at the University of Texas Southwestern Medical Center.

Dr. Flores recommends that physicians track disparities in their practices by routinely collecting data on race/ethnicity, primary language spoken and English proficiency. He said such information would help doctors identify inequities and track progress in eliminating gaps in the quality of minority health care.

Also in the April Pediatrics, the AAP published a policy statement on health equity and children's rights (link).

The statement recommends that physicians work with communities to ensure the equitable delivery of health services to children. The AAP also suggests that doctors advocate for changes that improve the environments in which their patients live.