A survey of two papers published in The Lancet Child and Youth Health; Pediatric health care for non-white children found to be generally poor across the United States
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A survey of two papers published in The Lancet Child and Youth Health; Pediatric health care for non-white children found to be generally poor across the United States
ER Productions Limited/Getty Images
Imagine your child has a broken bone. You go to the emergency room, but the doctor doesn't prescribe painkillers. According to , this scenario is one that children of color in the United States are more likely to face than white children. new discovery was announced on The Lancet Child and Adolescent Health.
Researchers reviewed dozens of recent studies that examined the quality of care children receive across a wide range of pediatric specialties.They say inequality is widespread. Dr. Nia Heard Garris, Northwestern University researcher and pediatrician at Chicago's Lurie Children's Hospital who oversaw the review.
“Everywhere you look, there are disparities in care for Black Americans, Hispanics, Latinos, Asian Americans, almost every race and ethnicity other than white,” she says.
Hurd-Garris says there are many examples of inequalities between specialties. The review found that children of color were less likely to receive diagnostic imaging and more likely to experience complications during and after some surgical procedures. They wait longer for care in the ER and are less likely to receive a diagnosis and treatment for a developmental disorder.
The strongest evidence of discordance was found in pain management. Children of color are less likely than white children to obtain pain medication for a broken arm or leg, appendicitis or migraine. “These are very harsh examples of how this could play out,” he says Dr. Monique Jindalan assistant professor at the University of Illinois at Chicago, is one of the authors of the review.
The researchers only looked at studies that included children with health insurance, “so we can't blame lack of insurance for causing these disparities,” Hurd-Garris said.
Gathering evidence of health inequalities from a wide range of pediatric specialties was a “tremendous” task, he says. Dr. Monica Goyalassociate director of emergency medicine at Children's National Hospital, was not involved in the review of the study.
“They have done a great job of painstakingly compiling data that highlights the pervasiveness of inequalities in care,” said Goyal, whose research has examined disparities in pediatric care. he says.
Researchers say that while the causes of inequality are manifold, it ultimately boils down to unequal access to healthy housing and economic opportunity, discriminatory policing of children of color, and unconscious bias among health care workers. It says it is rooted in systemic racism, including prejudice.
“Anyone with open eyes knows that disparities exist. What we're really missing is talking about concrete solutions,” he says. JindalHe was the lead author of a companion paper that provided policy recommendations to combat these widespread disparities in pediatric health care.
These solutions may ultimately require fundamental policy changes, Jindal said. This is because “we cannot achieve quality or equitable health care unless we address each policy issue with other sectors of society.”
However, fundamental policy changes can take a long time, and some policies, such as the introduction of universal healthcare, have proven politically unfeasible in the past. Jindal said there are some low-hanging fruit that can be worked on at the state level, such as creating continued eligibility for social safety net programs like SNAP, Medicaid and CHIP to ensure children don't lose coverage or food. says. Assistance for administrative reasons.
In the meantime, Hurd-Garris said healthcare providers should take immediate steps to check their practice for bias.
“Even if you are the most progressive provider, there will still be blinders,” she says. Hurd-Gallis advises checking them out, challenging yourself, learning more, improving yourself, and reviewing your charts.
This article was edited by Jane Greenhalgh
