Faculty Collaboration Database

Pediatric otolaryngologic conditions: Racial and socioeconomic disparities in the United States. Laryngoscope 2017 Mar;127(3):746-752

Date

09/08/2016

Pubmed ID

27599638

DOI

10.1002/lary.26240

Scopus ID

2-s2.0-84994018030 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

OBJECTIVES/HYPOTHESIS: Determine the national incidence and disparities for common pediatric otolaryngologic conditions.

STUDY DESIGN: Cross-sectional analysis of a nationally representative database.

METHODS: The National Health Interview Survey (2012) was analyzed, extracting children with frequent ear infections (FEI), nonstreptococcal sore throat (NSST), streptococcal pharyngitis (SP), hay fever, and sinusitis. Demographic data including age, sex, race, Hispanic ethnicity, geographic region, poverty level, and insurance status were extracted. The annual incidences of these conditions were determined. Disparities in the incidence of each condition was determined according to race and ethnicity, adjusting for other demographic variables.

RESULTS: Among 73.3 million children (average age, 8.6 years; 51.1% male), the incidences were: FEI (4.0 million, 5.5% of children), NSST (11.9 million, 20.6% of children), SP (8.0 million, 13.8% of children), hay fever (6.6 million, 9.0% of children), and sinusitis (4.5 million, 7.9% of children). Black and Hispanic children were less likely to be diagnosed with FEI than white children (odds ratio: 0.503 [95% confidence interval: 0.369-0.686] and odds ratio: 0.661 [95% confidence interval: 0.515-0.848]), adjusting for all other demographic variables. Black and Hispanic children were also less likely to be diagnosed with SP than white children (odds ratio: 0.433 [95% confidence interval: 0.342-0.547] and odds ratio: 0.487 [95% confidence interval: 0.401-0.592], respectively). Similar decreased odds ratios for black and Hispanic children were evident for hay fever (odds ratio: 0.704 [95% confidence interval: 0.556-0.890] and odds ratio: 0.708 [95% confidence interval: 0.565-0.888], respectively) and for sinusitis (odds ratio: 0.701 [95% confidence interval: 0.543-0.905] and odds ratio: 0.596 [95% confidence interval:0.459-0.773], respectively).

CONCLUSIONS: Black and Hispanic children are consistently less likely to be identified or diagnosed with FEI, hay fever, SP, and sinusitis compared to white children. These data likely highlight a significant health care disparity according to race/ethnicity in otolaryngology.

LEVEL OF EVIDENCE: 2b Laryngoscope, 127:746-752, 2017.

Author List

Shay S, Shapiro NL, Bhattacharyya N

Author

Sophie G. Shay MD Associate Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Age Distribution
Child
Child, Preschool
Chronic Disease
Cross-Sectional Studies
Databases, Factual
Female
Health Status Disparities
Health Surveys
Humans
Incidence
Infant
Insurance Coverage
Male
Otorhinolaryngologic Diseases
Risk Assessment
Sex Distribution
Socioeconomic Factors
United States