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Race and ethnicity influenced access to care for children with frequent ear infections
Bhattacharyya N. Otolaryngol Head Neck Surg. 2010;143:691-696.
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Compared with white children, black and Hispanic children had less access to health care and were more likely to visit the ED for an ear infection.
Researchers at the David Geffen School of Medicine at UCLA and Harvard Medical School conducted a study to provide an accurate demographic picture of the US to identify disparities to target for intervention.
“Clearly, we found that children of certain ethnicities who suffer from frequent ear infections are more likely to face greater barriers to care,” Nina Shapiro, MD, said in a press release. Shapiro is director of pediatric otolaryngology at Mattel Children’s Hospital UCLA and associate professor of surgery at the Geffen School of Medicine at UCLA.
The researchers reviewed data from the National Health Interview Survey (1997-2006) to identify children who had frequent ear infections, defined as at least three in the preceding year, and analyzed results, including age, sex, race/ethnicity, income level, insurance status and access to care.
There were 4.6 million children who reportedly had frequent ear infections. Among these children, 3.7% could not afford care, 5.6% could not afford prescriptions and only 25.8% saw a specialist.
More black children (42.7%) and Hispanic children (34.5%) lived below the poverty level than white children (12%) and those of other ethnicity (28%). Compared with whites (6.5%), more Hispanics (18.2%) and children of other ethnicity (16.6%) were uninsured.
More whites (29.2%) had access to specialty care vs. blacks (20%), Hispanics (17.5%) and children of other ethnicity (18.9%). During a period of 12 months, more black children (28.4%) and Hispanic children (19.8%) visited the ED at least two times for ear infections.
In multivariate analysis, when compared with white children, black and Hispanic children were at increased odds for not being able to afford prescription medications (OR=1.76; OR=1.47; respectively) and not being able to see a specialist (OR=1.62; OR=1.86; respectively); black (OR=2.50) and Hispanic children (1.32) were also more likely to visit the ED for an ear infection.
“This information provides an opportunity for improvements in our current health care reform,” Shapiro said.
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