Maigné Méloë, Côté-Corriveau Gabriel, Ayoub Aimina, Bilodeau-Bertrand Marianne, Auger Nathalie
Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.
Institut national de santé publique du Québec, Montreal, QC, Canada.
J Racial Ethn Health Disparities. 2024 Sep 3. doi: 10.1007/s40615-024-02151-5.
In the U.S., Black children have disproportionately elevated rates of pediatric morbidity compared with White children, but data are lacking for other countries. We studied the extent to which Black Haitians were at risk of pediatric morbidity in Canada.
We analyzed a retrospective cohort of 736,498 children born in Quebec between 2008 and 2020. We identified Black Haitians using the mother tongue and birth country of parents. The outcome was mortality or hospitalization for infectious diseases, allergy, cancer, and other morbidity between birth and 12 years of age. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for these outcomes, comparing Haitians with non-Haitians in Cox regression models adjusted for patient characteristics.
Compared with non-Haitians, Haitians tended to have a greater risk of pediatric mortality, especially before age 2 years (HR 1.56, 95% CI 1.00-2.45). However, Haitian children had a lower risk of hospitalization than non-Haitian children (HR 0.61, 95% CI 0.59-0.63). Haitians were less likely to be hospitalized for infectious diseases, allergies, appendicitis, cancers, fractures, dental caries, and ophthalmologic conditions. Hospitalization rates were low throughout childhood, even though Haitian children were more likely to be born preterm, develop severe neonatal morbidity, and have other adverse outcomes at birth.
Haitian children have an elevated risk of neonatal morbidity and early childhood mortality, but lower risk of hospitalization compared with non-Haitians in Canada. The reasons for the disparity are unclear, but greater effort is needed to address potential gaps in healthcare among Black children.
在美国，与白人儿童相比，黑人儿童的儿科发病率不成比例地升高，但其他国家缺乏相关数据。我们研究了加拿大海地黑人儿童患儿科疾病的风险程度。
我们分析了2008年至2020年在魁北克出生的736498名儿童的回顾性队列。我们根据父母的母语和出生国家来确定海地黑人。结局是出生至12岁之间因传染病、过敏、癌症和其他疾病导致的死亡或住院。在根据患者特征进行调整的Cox回归模型中，我们估计了这些结局的风险比（HR）和95%置信区间（CI），并将海地人与非海地人进行比较。
与非海地人相比，海地人儿科死亡风险往往更高，尤其是在2岁之前（HR 1.56，95% CI 1.00 - 2.45）。然而，海地儿童住院风险低于非海地儿童（HR 0.61，95% CI 0.59 - 0.63）。海地人因传染病、过敏、阑尾炎、癌症、骨折、龋齿和眼科疾病住院的可能性较小。尽管海地儿童更有可能早产、出现严重的新生儿疾病以及在出生时出现其他不良结局，但整个儿童期的住院率都很低。
与加拿大的非海地人相比，海地儿童新生儿疾病和幼儿期死亡风险升高，但住院风险较低。这种差异的原因尚不清楚，但需要做出更大努力来解决黑人儿童在医疗保健方面的潜在差距。
