Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA.
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
Cardiol Young. 2023 Dec;33(12):2539-2547. doi: 10.1017/S1047951122004097. Epub 2023 Mar 31.
Among children with and without heart conditions of different race/ethnicities, upstream social determinants of health, such as socio-economic status, access to care, and healthcare utilisation, may vary. Using caregiver-reported data from the 2016-19 National Survey of Children's Health, we calculated the prevalence of caregiver employment and education, child's health insurance, usual place of medical care in the past 12 months, problems paying for child's care, ≥2 emergency room visits, and unmet healthcare needs by heart condition status and race/ethnicity (Hispanic, non-Hispanic Black, and non-Hispanic White). For each outcome, we used multivariable logistic regression to generate adjusted prevalence ratios controlling for child's age and sex. Of 2632 children with heart conditions and 104,841 without, 65.4% and 58.0% were non-Hispanic White and 52.0% and 51.1% were male, respectively. Children with heart conditions, compared to those without, were 1.7-2.6 times more likely to have problems paying for healthcare, have ≥2 emergency room visits, and have unmet healthcare needs. Hispanic and non-Hispanic Black children with heart conditions, compared to non-Hispanic White, were 1.5-3.2 times as likely to have caregivers employed <50 weeks in the past year and caregivers with ≤ high school education, public or no health insurance, no usual place of care, and ≥2 emergency room visits. Children with heart conditions, compared to those without, may have greater healthcare needs that more commonly go unmet. Among children with heart conditions, Hispanic and non-Hispanic Black children may experience lower socio-economic status and greater barriers to healthcare than non-Hispanic White children.
在不同种族/族裔的有和无心脏疾病的儿童中，社会经济地位、获得医疗保健的机会和医疗保健利用等上游健康决定因素可能有所不同。我们使用 2016-19 年全国儿童健康调查中护理人员报告的数据，计算了护理人员就业和教育程度、儿童健康保险、过去 12 个月的常规医疗地点、儿童护理费用支付问题、≥2 次急诊就诊和未满足的医疗保健需求的发生率，按心脏疾病状况和种族/族裔（西班牙裔、非西班牙裔黑人、非西班牙裔白人）进行分类。对于每个结果，我们使用多变量逻辑回归生成调整后的患病率比，控制儿童的年龄和性别。在 2632 名患有心脏疾病的儿童和 104841 名没有心脏疾病的儿童中，分别有 65.4%和 58.0%是非西班牙裔白人，52.0%和 51.1%是男性。与没有心脏疾病的儿童相比，患有心脏疾病的儿童更有可能出现支付医疗保健费用的问题、≥2 次急诊就诊和未满足的医疗保健需求，患病儿童的可能性是无病儿童的 1.7-2.6 倍。与非西班牙裔白人相比，患有心脏疾病的西班牙裔和非西班牙裔黑人儿童过去一年中更有可能出现护理人员工作<50 周和护理人员接受过≤高中教育、公共或没有医疗保险、没有常规医疗地点和≥2 次急诊就诊的情况，患病儿童的可能性是无病儿童的 1.5-3.2 倍。与没有心脏疾病的儿童相比，患有心脏疾病的儿童可能有更多未满足的医疗保健需求。与非西班牙裔白人相比，患有心脏疾病的西班牙裔和非西班牙裔黑人儿童可能面临更低的社会经济地位和更大的医疗保健障碍。
