Black and Hispanic children underrepresented at diabetes summer camps
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During 2018, black and Hispanic children attended diabetes summer camps less frequently than white children, according to findings published in Diabetes Care.
“Diabetes camps offer a lot of benefits to youth with diabetes and should be accessible to all children,” Risa M. Wolf, MD, assistant professor of pediatrics at Johns Hopkins Medicine, told Healio. “Racial disparities exist in many aspects of diabetes care and outcomes, including diabetes camp attendance. Therefore, we need to identify what the barriers are and address them to make camp attendance more inclusive.”
Using a registration database, Wolf and colleagues assessed the racial and ethnic makeup, continuous glucose monitor usage, insulin delivery technique, camp type and financial aid requirements of 5,256 children (mean age, 11.8 years; 55% girls) who attended American Diabetes Association-affiliated summer camps in 2018.
Among the cohort, 16.3% of participants were of nonwhite ethnicity. The researchers’ analysis, which incorporated 2009 SEARCH for Diabetes in Youth data on prevalence of type 1 diabetes among U.S. children by ethnicity, revealed that camp attendance was “less likely” for black, Hispanic and Pacific/Islander children and “more likely” for white and American Indian children.
Among those who attended camp, 31.9% of Hispanic children, 23.3% of black children and 20% of white children went to day camp vs. residential camp. In addition, 48.4% of black children, 44% of Hispanic children and 29.2% of white children were going to camp for the first time. In order to attend, 65.6% of black children, 48.1% of Hispanic children and 24.3% of white children applied for financial aid.
Insulin was delivered via pump for 39.1% of black children, 60.3% of Hispanic children and 76.4% of white children while 23.4% of black children, 46.1% of Hispanic children and 61% of white children used CGM. Mean HbA1c was 9.5% among black children, 8.8% among Hispanic children and 8.2% among white children.
“Johns Hopkins pediatric endocrinology and the ADA started a new diabetes camp, Camp Charm City, in summer 2019 that is a day camp, located in Baltimore City, with a very low registration cost; 31% of children in attendance were minority youth,” Wolf said. “Similar initiatives to this one may help increase accessibility and reduce these disparities.” – by Phil Neuffer
For more information:
Risa M. Wolf, MD, can be reached at rwolf@jhu.edu.
Disclosures: Wolf reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
Perspective
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Carla Cox, PhD, RD, DCES
This article did an excellent job of reviewing the present climate of attendance of a variety of ethnic groups at diabetes camps and comparing the results to the incidence of diabetes in these same groups. Often our assumption is that this discrepancy is due to lack of access, whether due to financial or location barriers. The next step is to improve our understanding of why this discrepancy exists and if, indeed, the positive impact of camp would translate to all populations.
As camp enthusiasts, we want all children to attend diabetes camp for the variety of positive outcomes that are outlined in this paper — including increased diabetes-related knowledge, glycemic control and improved psychological functioning.
Two questions arise: Why are they not attending ADA diabetes camps at the same participation rate? ADA camps are available to all without regard to ability to pay, so payment is not the barrier. It is illogical that provider offices only suggest camp for certain ethnic groups and not others — so knowledge of their existence should not be a barrier.
The next step is to discover the reasons for a lower attendance rate, as discussed in the conclusion. Qualitative research with focus groups may provide some insight and suggestions for change. For example, would a family camp or one that provides the opportunity to bring a sibling or best friend be of greater interest to certain ethnic groups? Or more day camps or family activities, such as biking, hiking, bowling, etc, to provide support to children and families who may not have the desire to attend a traditional camp?
In addition, research into the impact of camp on different populations may also be insightful. We assume all children will respond in like manner, but that may not be the case. More family-focused camps and day activities may provide greater interest and support and improved outcomes in different ethnic groups.
I appreciate the information presented and hope it will encourage others to pursue these questions to determine not just the what, but the why and to establish a “what’s next?”
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