Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Jan;161(1):30-6.
doi: 10.1001/archpedi.161.1.30.

Disparities in pediatric preventive care in the United States, 1993-2002

Affiliations

Disparities in pediatric preventive care in the United States, 1993-2002

Simon J Hambidge et al. Arch Pediatr Adolesc Med. 2007 Jan.

Abstract

Objectives: To quantify physician-reported preventive counseling and screening during well-child visits (WCVs) and to examine racial and ethnic disparities in these activities.

Design: Cross-sectional study using the National Ambulatory Medical Care Survey, January 1993 through December 2002.

Setting: Office-based physician practices.

Participants: Children from birth to 18 years old who were seen by a physician for a WCV.

Main outcome measure: Preventive counseling and screening.

Results: Well-child visits were shorter for Latino children than for white or black children. At WCVs, white children were more likely to receive preventive counseling than were black or Latino children (72% vs 61% vs 61%, respectively; P = .01) but not more likely to receive screening for elevated blood pressure, anemia, vision and hearing acuity, or lead toxicity. There were no differences in secondary diagnoses made at WCVs for white, black, or Latino children (15% vs 17% vs 14%, respectively; P = .65). The children who received the least counseling were Latino children in the public sector non-health maintenance organization setting (counseled at 39% of visits) and Latino children who self-paid for the visits (counseled at 26% of visits). After adjusting for possible confounders, including medications prescribed at the visit, black and Latino children were less likely to receive counseling than were white children (odds ratios, 0.68 and 0.63; 95% confidence interval, 0.48-0.97 and 0.44-0.90, respectively), and black children were less likely to receive preventive screening services (odds ratios, 0.65; 95% confidence interval, 0.45-0.93).

Conclusions: By physician report in a nationally representative sample, black and Latino children received less counseling at WCVs than did white children. These disparities were unexplained by the competing demands of other secondary diagnoses or medications prescribed or dispensed.

PubMed Disclaimer

Publication types

LinkOut - more resources