Study finds disparities in pediatric care disruption during pandemic
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Urban families, Black and multiracial children and families with low socioeconomic status faced the highest rates of pediatric care disruption during the COVID-19 pandemic, a study found.
The study, published in JAMA Pediatrics, is the latest to find that the pandemic has affected medical care for children, with disruptions also reported in vaccination efforts and children with special health needs.
Co-authors Kelsi Batioja, BS, and Covenant C. Elenwo, MPH are medical students at the Oklahoma State University College of Osteopathic Medicine at Cherokee Nation. Batioja, who is in her third year of school, told Healio that the study was prompted by what she heard from patients during rotations.
“I had a lot of patients that were talking about having to cancel appointments over the last few years because of COVID-19,” Batioja said. “That piqued my interest in seeing if it was true for other patients elsewhere.”
Batioja, Elenwo and Micah Hartwell, PhD, of the department of psychiatry and behavioral sciences at Oklahoma State University Center for Health Sciences, assessed data from the 2021 National Survey of Children’s Health.
“[The survey] is a publicly available data set that collects data on different aspects of children's life like mental [and] physical health, neighborhood they live in, social contexts and the child's family,” Elenwo said. “The surveys are usually completed online or by mail, by the child's primary caregiver that lives in the home.”
The survey’s questions examine sociodemographic variables, such as race and ethnicity, socioeconomic status and whether during the COVID-19 pandemic preventive checkups were missed, delayed or skipped; regular child care arrangements were unavailable at any time; medical visits were by telehealth; and telehealth visits were scheduled because of COVID-19.
Among a sample group of 49,102 respondents, the authors found “significant associations” between race and ethnicity, particularly among Black and multiracial families, and disrupted preventive checkups (2, 3.24; P=.01) and child care arrangements (2, 4.03; P=.003). They also observed significant associations between lower socioeconomic status and disrupted child care arrangements (2, 46.78; P<.001), telehealth visits (2, 15.59; P<.001) and telehealth visits for COVID-19 (2, 3.44; P=.02).
“These observations support a retrospective chart review of pediatric patients receiving care between April 2019 and April 2020 that found substantial decreases for well visits and chronic condition follow-ups during the pandemic,” the authors wrote. “Compared with white patients, Black and other minority patients had significantly lower odds of attending a telehealth visit, likely associated with inequities in broadband access, available technology, or mistrust of medical institutions.”