This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (48)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Adolescent Medicine  • Quality of Care, Other  • Review  • Alert me on articles by topic  Social Bookmarking   What's this?

A Systematic Review of the Literature

Arthur Elster, MD; Julie Jarosik, MPH; Jonathan VanGeest, PhD; Missy Fleming, PhD

Arch Pediatr Adolesc Med. 2003;157:867-874.

Objective  To identify the extent of racial and ethnic disparities in primary care, mental health care, reproductive health care, and asthma care for adolescents independent of socioeconomic status (SES).

Data Sources  Systematic review of the scientific literature using standard bibliographic databases.

Study Selection  Inclusion criteria were (1) studies published in the past 12 years, (2) analyses included children and adolescents aged 17 years and younger, and (3) data analyzed by racial/ethnic groups while accounting for SES. A total of 203 studies were reviewed, of which 31 met the criteria for inclusion: 14 of 65 studies on primary care, 11 of 61 studies on mental health care, 2 of 50 studies on reproductive health, and 4 of 27 studies on asthma services.

Data Extraction  Data from tables in the selected studies were used to determine whether minority children and adolescents received fewer, greater, or the same health care services as white children and youth after taking into account SES.

Data Synthesis  Black youth received fewer primary care services in 8 studies, whereas in 4 studies no disparity was noted. Hispanic youth received fewer primary care services in 6 studies, whereas no disparity was noted in 5. One study did not include Hispanic subjects. In 2 studies minority youth, combined into a single category, received fewer services than did white youth. In a total of 6 studies black youth received fewer mental health services, whereas in 3 studies no disparity was noted and in 1 study black youth received a greater number of services. In 3 studies Hispanic youth received fewer mental health services, and in 3 studies there were no group differences. In 1 study, with racial and ethnic groups combined in a single category, minority children and youth received fewer mental health services than white subjects. Three studies did not include Hispanic subjects. Too few studies of reproductive and asthma care were available to draw conclusions.

Conclusions  These results suggest that racial and ethnic disparities, independent of SES, exist in selected areas of adolescent health care. More studies are needed to better understand the extent and causes of these findings.

From the American Medical Association, Chicago, Ill.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Eliminating Health Care Disparities Is Good for Us All
Alain Joffe
Arch Pediatr Adolesc Med. 2003;157(9):850-851.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Outcomes for Youths From Racial-Ethnic Minority Groups in a Quality Improvement Intervention for Depression Treatment
Ngo et al.
Psychiatr. Serv. 2009;60:1357-1364.
ABSTRACT | FULL TEXT  

Depression, Sexually Transmitted Infection, and Sexual Risk Behavior Among Young Adults in the United States
Khan et al.
Arch Pediatr Adolesc Med 2009;163:644-652.
ABSTRACT | FULL TEXT  

Additional Visit Burden for Universal Influenza Vaccination of US School-Aged Children and Adolescents
Rand et al.
Arch Pediatr Adolesc Med 2008;162:1048-1055.
ABSTRACT | FULL TEXT  

Racial/Ethnic Disparities and Culturally Competent Health Care Among Youth and Young Men
Vo and Park
Am J Mens Health 2008;2:192-205.
ABSTRACT  

Delivering Adolescent Vaccinations in the Medical Home: A New Era?
Szilagyi et al.
Pediatrics 2008;121:S15-S24.
ABSTRACT | FULL TEXT  

Voices of Asian American Youth: Important Characteristics of Clinicians and Clinical Sites
Vo et al.
Pediatrics 2007;120:e1481-e1493.
ABSTRACT | FULL TEXT  

School-Based Health Centers: Improving Access and Quality of Care for Low-Income Adolescents
Allison et al.
Pediatrics 2007;120:e887-e894.
ABSTRACT | FULL TEXT  

National Health Care Visit Patterns of Adolescents: Implications for Delivery of New Adolescent Vaccines
Rand et al.
Arch Pediatr Adolesc Med 2007;161:252-259.
ABSTRACT | FULL TEXT  

Enrolling Vulnerable, Uninsured but Eligible Children in Public Health Insurance: Association With Health Status and Primary Care Access
Stevens et al.
Pediatrics 2006;117:e751-e759.
ABSTRACT | FULL TEXT  

Racial and Socioeconomic Disparity in Perforated Appendicitis Among Children: Where Is the Problem?
Nwomeh et al.
Pediatrics 2006;117:870-875.
ABSTRACT | FULL TEXT  

On-Time Immunization Rates Among Children Who Enter Chicago Public Schools
Dominguez et al.
Pediatrics 2004;114:e741-e747.
ABSTRACT | FULL TEXT  

Policies To Reduce Racial And Ethnic Disparities In Child Health And Health Care
Beal
Health Aff (Millwood) 2004;23:171-179.
ABSTRACT | FULL TEXT  

The science of recruiting minority populations to screening trials
Ford and Howerton
Clin Trials 2004;1:341-342.
 

Quality of Care in Medicaid Managed Care vs Commercial Managed Care Plans
Wood and Jatulis
JAMA 2004;291:1196-1196.
FULL TEXT  

Correlates of Use of Specialty Care
Kuhlthau et al.
Pediatrics 2004;113:e249-255.
ABSTRACT | FULL TEXT  

Primary Care Access and Quality: Two Sides of the Same Coin
Stevens and Shi
Arch Pediatr Adolesc Med 2004;158:185-185.
FULL TEXT  

Eliminating Health Care Disparities Is Good for Us All
Joffe
Arch Pediatr Adolesc Med 2003;157:850-851.
FULL TEXT