Children’s extreme health inequality

A new systematic review of hundreds of research studies finds pervasive inequality by race/ethnicity in health and health care among children in the U.S. The report, by Glenn Flores and the Committee on Pediatric Research, was published online by the journal Pediatrics.

After collecting more than 700 articles, they selected 111 that met their review criteria. Their conclusion:

Disparities were noted across the spectrum of health and health care, including in mortality rates, access to care and use of services, prevention and population health, health status, adolescent health, chronic diseases, special health care needs, quality of care, and organ transplantation. Mortality-rate disparities were noted for children in all 4 major US racial/ethnic minority groups, including substantially greater risks than white children of all-cause mortality; death from drowning, from acute lymphoblastic leukemia, and after congenital heart defect surgery; and an earlier median age at death for those with Down syndrome and congenital heart defects.
And that’s a short list of the disparities uncovered. Some of the more shocking disparities are in things I never considered. Take the age at death for people with Down syndrome. There has been dramatic improvement in life expectancy in this group, who used to die on average before age 5. By the early 1990s survival for Whites had surpassed age 40 — but it was still under 10 for Blacks. By the late 1990s, the White survival was still twice as long as that for African Americans.
The studies are all detailed and referenced in the article. Almost 80% of the studies reviewed included statistical adjustments to help rule out confounding factors. However, it’s important to remember that race/ethnic disparities don’t have to be caused by race/ethnicity in order to be socially or morally wrong. Even if the inequality is caused by poverty, living in polluted areas, blocked access to health care, worse health behavior by parents, or unknown causes — the observed inequality is still real life for the children affected.

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