A systematic review of racial health disparities among children and youth with physical disabilities

Abstract

Purpose: Children and youth who belong to a racially minoritized group commonly experience multiple and complex forms of discrimination and health disparities. The purpose of this review was to explore racial disparities in health care and health outcomes among children and youth with physical disabilities.

Methods: Six international databases (Ovid Medline, Healthstar, Embase, PsycINFO, Scopus, and Web of Science) were searched and screened for inclusion. A narrative synthesis was used to identify the common trends.

Results: Thirty-seven articles met the inclusion criteria, which involved 218 555 children and youth with various types of physical disabilities spanning over 29 years. We noted the following trends: (1) racial disparities in accessing or receiving care; (2) racial disparities in health outcomes and mortality rates; and (3) factors affecting racial disparities. Most studies reported at least one finding indicating that racially minoritized youth had differential access to care and/or disparities in health outcomes compared to white youth.

Conclusions: Our findings highlight the concerning racial disparities among children and youth with physical disabilities within health care. There is an urgent need for advocacy and interventions at multiple levels to address the perpetual racism and racial disparities that racially minoritized youth with physical disabilities experience.Implications for rehabilitationThere is an urgent need for health care leaders and health care providers to address the systemic health inequalities in rehabilitation for racially minoritized children and youth with physical disabilities.Health care leaders and clinicians should recognize the racial disparities that racially minoritized youth with physical disabilities encounter in accessing or receiving care in addition to health outcomes.Health care leaders and decision-makers should advocate for policy change to optimize equitable and inclusive health care to enhance the well-being of racially minoritized children with disabilities.Health care providers should engage in training to understand how to recognize and address how intersectional forms of a child's identity such as disability, race, and socio-economic status can influence health care experiences and health outcomes.

Keywords: Access to care; children; discrimination; physical disability; racial disparities; racism; youth.