HEALTH DISPARITIES IN HEALTH CARE FOR CHILDREN

HEALTH DISPARITIES IN HEALTH CARE FOR CHILDREN

Health disparities are defined as the differences that remain after taking into account patients' needs and preferences and the availability of health care. Social conditions, social inequity, discrimination, social stress, language barriers, and poverty are antecedents to and associated causes of health disparities. The disparities in infant mortality relate to poor access to prenatal care during pregnancy and the lack of access and appropriate heath services for women throughout their life span, such as preventive services, family planning, and appropriate nutrition and health care.

• Infant mortality increases as the mother's level of education decreases.


• Poorer children are less likely to be immunized at age 4 years and are less likely to receive dental care.


• Rates of hospital admission for treatable disease are higher for people who live in low-income areas.


• Children of ethnic minorities and children from poor families are less likely to have physician office or hospital outpatient visits and are more likely to have hospital emergency department visits.


• Access to care for children is easier for non-Hispanic whites and for children of higher income families than for minority and low-income families.

Other heath issues that represent challenges for pediatricians include the following:

• Although there was a decline in cigarette smoking in high school students from 36% in 1997 to 29% in 2001, more than a quarter of high school students still smoke.


• Among high school students, 38% of girls and 24% of boys do not engage in recommended amounts of moderate or vigorous physical activity.


• The prevalence of overweight children among those 6 to 11 years old doubled from 7% to 15% (1976-1980 to 1999-2000), and the prevalence of overweight adolescents among those 12 to 19 years old tripled from 5% to 16% during the same time. Obesity and its associated morbidities are a serious public health concern. It is estimated that 65% of U.S. adults are overweight or obese; this is associated with 300,000 deaths a year and at least $117 billion in healthcare costs.
  In 2000, it was estimated that $64.7 billion was spent treating injuries in the U.S., with injury-attributable medical expenses of $117.2 billion. For children up to 19 years old, the expenses for medical treatment were $24.4 billion, and attributed medical expenses were $29.1 billion. A significant percentage of injuries in adolescents are associated with alcohol abuse.


• In 1999-2000, the Head Start program served only 60% of eligible children. There were almost 13 million children in federal Title I reading programs, and greater than 6 million children qualified for disabilities under the Individuals with Disabilities Education Act.


• The school dropout rate for children was 14.5%.
  In 1999-2000, greater than 800,000 children were abused, approximately 500,000 children were in foster care, and 2.3 million were in the care of grandparents; 18.8% of children were living in poverty. In the same years, 1.7 million juveniles were arrested, 112,479 young people were in correctional institutions for juveniles, and 18.8% of these (21,130) were in adult prison facilities.