• Posted January 18, 2024

Non-White U.S. Kids Get Worse Pediatric Care

Pediatric care for kids who aren't white is worse across the United States, a new study finds.

Racial inequities for children of color are pervasive, extending from neonatal care, emergency medicine and surgery to treatment of developmental disabilities, mental health issues and pain, researchers say.

“We now have more evidence than ever that pediatric care in the U.S. is not only disparate, but inequitable for a large group of children,” said senior researcher Dr. Nia Heard-Garris, an assistant professor of advanced general pediatric and primary care at Northwestern University Feinberg School of Medicine in Chicago.

Overcoming these health inequities borne of structural racism will require policy changes across multiple sectors of society, including housing, health insurance and the criminal justice system, the researchers concluded.

“There are deeply entrenched racial disparities that span broad sectors of U.S. society and transcend generations,” researcher Dr. Monique Jindal, an assistant professor of clinical medicine with the University of Illinois Chicago School of Medicine.

“It is abundantly clear that to ensure every child in the U.S. receives the best possible health care, there is a critical need for far-reaching policy changes that directly address deep-rooted structural racism at its core,” Jindal said in a Northwestern news release.

For the report, researchers focused on differences in care quality that are not due to a lack of access to health services because a family doesn't have health insurance.

The strongest evidence of disparities was in pain management, researchers found.

Children from minority racial or ethnic groups were less likely than white peers to receive painkillers for conditions ranging from broken limbs to appendicitis to migraine.

Overall, white patients tended to receive more care -- such as more painkillers, antibiotics, IV fluids and diagnostic imaging -- even when the treatment was not justified on medical grounds.

Evidence also showed that children of minority racial and ethnic groups consistently receive lower-quality neonatal care, particularly Black and Hispanic kids.

These children also receive primary care that's hampered by a lack of communication from health care providers.

In the ER, minority children experienced differences in wait times, triage assessment and the evaluation of suspected child abuse, researchers found.

Black and Asian children are less likely to receive a timely diagnosis with a developmental disability before preschool or kindergarten, and Hispanic children with special health needs receive fewer specialist services.

Inequities also exist in mental health services, with lower rates of adequate care for depression and ADHD among Black, Hispanic and other minority children.

The new study was published Jan. 17 in The Lancet Child & Adolescent Health journal.

“From the very earliest moments of life, there are pervasive inequities in the quality of health care received by children in the U.S.,” said lead researcher Natalie Slopen, an assistant professor of social and behavioral sciences at Harvard University. “Racism profoundly impacts not only children's health but also people's health on into adulthood, emphasizing the vital importance of tackling disparities in the care received by children.”

Researchers recommended policy reforms aimed at reducing these inequities, including those that:

• Promote affordable and stable housing in good neighborhoods

• Increase access to health insurance and better-paying jobs

• Reform the criminal justice system and promote fair immigration policies

“We must fundamentally rethink and redesign systems and policies, not only in healthcare but across the societal spectrum, to promote equitable, excellent health for all children,” Slopen said.

More information

The U.S. Centers for Disease Control and Prevention has more about health equity.

SOURCE: Northwestern University, news release, Jan. 17, 2024