Davis Deborah Winders, Jawad Kahir, Feygin Yana B, Stevenson Michelle, Wattles Bethany, Jones Veronnie Faye, Porter Jennifer, Lohr W David, Le Jennifer
Department of Pediatrics, University of Louisville School of Medicine, 571 S. Floyd Street, Louisville, KY, 40202, USA.
Norton Children's Research Institute Affiliated With the University of Louisville School of Medicine, Louisville, KY, USA.
Child Psychiatry Hum Dev. 2024 Aug 27. doi: 10.1007/s10578-024-01751-w.
Childhood health disparities by race have been found. Neighborhood disadvantage, which may result from racism, may impact outcomes. The aim of the study is to describe the distribution of mental health (MH) and developmental disabilities (DD) diagnosis across Child Opportunity Index (COI) levels by race/ethnicity. A cross-sectional study using 2022 outpatient visit data for children < 18 years living in the Louisville Metropolitan Area (n = 115,738) was conducted. Multivariable logistic regression analyses examined the association between diagnoses and COI levels, controlling for sex and age. Almost 18,000 children (15.5%) had a MH or DD (7,905 [6.8%]) diagnosis. In each COI level, the prevalence of MH diagnosis was lower for non-Hispanic (N-H) Black than for N-H White children. In adjusted analyses, there were no significant associations between diagnoses and COI for non-White children for MH or DD diagnoses. The odds of receiving a MH [OR: 1.74 (95% CI: 1.62, 1.87)] and DD [OR: 1.69 (95% CI: 1.51, 1.88)] diagnosis were higher among N-H White children living in Very Low compared to Very High COI areas. Current findings suggest that COI does not explain disparities in diagnosis for non-White children. More research is needed to identify potential multi-level drivers such as other forms of racism. Identifying programs, policies, and interventions to reduce childhood poverty and link children and families to affordable, family-centered, quality community mental and physical health resources is needed to ensure that families can build trusting relationships with the providers while minimizing stigma.
研究发现了不同种族儿童在健康方面的差异。邻里环境不利可能源于种族主义，这可能会影响结果。本研究的目的是按种族/族裔描述心理健康（MH）和发育障碍（DD）诊断在儿童机会指数（COI）各水平上的分布情况。我们进行了一项横断面研究，使用了2022年居住在路易斯维尔都会区的18岁以下儿童的门诊就诊数据（n = 115,738）。多变量逻辑回归分析检验了诊断与COI水平之间的关联，并对性别和年龄进行了控制。近18,000名儿童（15.5%）被诊断患有MH或DD（7,905名[6.8%]）。在每个COI水平上，非西班牙裔（N-H）黑人儿童的MH诊断患病率低于N-H白人儿童。在调整分析中，非白人儿童的MH或DD诊断与COI之间没有显著关联。与COI水平非常高的地区相比，居住在COI水平非常低的地区的N-H白人儿童被诊断患有MH[比值比（OR）：1.74（95%置信区间：1.62, 1.87）]和DD[OR：1.69（95%置信区间：1.51, 1.88）]的几率更高。目前的研究结果表明，COI并不能解释非白人儿童在诊断方面的差异。需要更多的研究来确定潜在的多层次驱动因素，如其他形式的种族主义。需要确定相关项目、政策和干预措施，以减少儿童贫困，并将儿童及其家庭与负担得起的、以家庭为中心的优质社区心理健康和身体健康资源联系起来，以确保家庭能够与提供者建立信任关系，同时尽量减少耻辱感。
