Guevara J, Mandell D, Rostain A, Huaqing Z, Hadley T; AcademyHealth. Meeting (2003 : Nashville, Tenn.).
Abstr AcademyHealth Meet. 2003; 20: abstract no. 113.
The Children's Hospital of Philadelphia, Division of General Pediatrics, 34th and Civic Center Blvd, Philadelphia, PA 19104 Tel. (215) 590-1130 Fax (215) 590-0426
RESEARCH OBJECTIVE: Previous research has suggested disparities in the diagnosis and treatment of behavioral problems in children. Little is known from a national perspective regarding whether differences in the diagnosis of behavioral disorders exist between children of different race/ethnicity. To test the hypothesis that Hispanic and black children as compared to white/other children are less likely to be diagnosed with emotional and disruptive behavioral disorders and to receive fewer health services. STUDY DESIGN: In a retrospective cohort study, children aged 2 to 18 years who were members of households participating in the 1996 Medical Expenditure Panel Survey were eligible. POPULATION STUDIED: Children were categorized as Hispanic, black, and white/other race by parent report. Common behavioral disorders and service use were compared among eligible children. Estimates were weighted to reflect the complex sampling scheme. PRINCIPAL FINDINGS: In 1996, 3955 eligible children weighted to represent over 44 million children reported information on behavioral and physical disorders and service use. Of these, 13.5% were Hispanic, 14.1% black, and 72.4% white/other. After controlling for demographic and healthcare access characteristics, Hispanic children were less likely to have a disruptive behavioral disorder (Adjusted OR 0.35, 95% CI 0.20 to 0.62) and black children were less likely to have an emotional disorder (Adjusted OR 0.29, 95% CI 0.12 to 0.71) than white/other children. Among those with behavioral disorders, black children made fewer ambulatory visits (Adjusted IRR 0.53, 95% CI 0.30 to 0.96) and received fewer prescription medications (Adjusted IRR 0.50, 95% CI 0.30 to 0.82) than white/other children, while Hispanic children were not different from white/other children in their service use. CONCLUSIONS: In this nationally representative sample, Hispanic and black children were less likely to report a behavioral disorder. In addition, black children with behavioral disorders used fewer services. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Future research should focus on efforts to determine the causes of behavioral health disparities in children and to design interventions to improve the recognition and treatment of these disorders in under-represented minorities.
Publication Types:
Keywords:
- African Americans
- African Continental Ancestry Group
- Child
- Cohort Studies
- Continental Population Groups
- Ethnic Groups
- European Continental Ancestry Group
- Federal Government
- Health Expenditures
- Health Services
- Health Services Accessibility
- Health Services Needs and Demand
- Hispanic Americans
- Humans
- Retrospective Studies
- diagnosis
- economics
- therapy
- hsrmtgs
Other ID:
UI: 102275098
From Meeting Abstracts