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Dr. Nina Shapiro and Colleagues Give a Demographic Earful

co author Dr. Nina ShapiroThe study also shows that African American and Hispanic children are more likely than white children to visit the emergency room for an ear infection.

“Our goal was to provide an accurate demographic picture of the U.S. so that we could identify disparities to target for intervention,” said study co-author Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital UCLA and an associate professor of surgery at the Geffen School of Medicine. “Clearly, we found that children of certain ethnicities who suffer from frequent ear infections are more likely to face greater barriers to care. This information provides an opportunity for improvements in our current health care reform.”

Researchers used data from a 10-year period (1997–2006) taken from the National Health Interview Survey, a large-scale, household-based survey of a statistically representative sample of the U.S. population.

Findings include:
A greater percentage of African American children (42.7 percent) and Hispanic children (34.5 percent) lived below the poverty level than white children (12.0 percent) and those of “other ethnicity” (28.0 percent).

A greater percentage of Hispanic children (18.2 percent) and “other ethnicity” children (16.6 percent) were uninsured, compared with whites (6.5 percent).

A greater percentage of white children (29.2 percent) reported having access to specialty care than African American children (20.0 percent), Hispanic children (17.5 percent) and “other ethnicity” children (18.9 percent).

A greater percentage of African American children (28.4 percent) and Hispanic children (19.8 percent) visited the emergency room at least twice for ear infections over a 12-month period than white children (15.5 percent).

“Emergency room visits for ear infections by African American and Hispanic children may represent their source of primary care services, which is more costly and a significant burden on the health care system,” Shapiro said. “This finding, along with the fact that fewer Hispanic and African American children were insured or received specialty care, highlights the importance of targeting interventions that help children with frequent ear infections.”

The next stage of the research is to follow the racial and ethnic groups prospectively and to monitor whether changes stemming from health care reform influence disparities in these groups over time.

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