Lindsay Sally, Leo Sarah, Phonepraseuth Janice, Cao Peiwen
Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada.
Disabil Rehabil. 2024 Dec 19:1-23. doi: 10.1080/09638288.2024.2427347.
Children and youth who belong to a racially minoritized group commonly experience multiple and complex forms of discrimination and health disparities. The purpose of this review was to explore racial disparities in health care and health outcomes among children and youth with physical disabilities.
Six international databases (Ovid Medline, Healthstar, Embase, PsycINFO, Scopus, and Web of Science) were searched and screened for inclusion. A narrative synthesis was used to identify the common trends.
Thirty-seven articles met the inclusion criteria, which involved 218 555 children and youth with various types of physical disabilities spanning over 29 years. We noted the following trends: (1) racial disparities in accessing or receiving care; (2) racial disparities in health outcomes and mortality rates; and (3) factors affecting racial disparities. Most studies reported at least one finding indicating that racially minoritized youth had differential access to care and/or disparities in health outcomes compared to white youth.
Our findings highlight the concerning racial disparities among children and youth with physical disabilities within health care. There is an urgent need for advocacy and interventions at multiple levels to address the perpetual racism and racial disparities that racially minoritized youth with physical disabilities experience.Implications for rehabilitationThere is an urgent need for health care leaders and health care providers to address the systemic health inequalities in rehabilitation for racially minoritized children and youth with physical disabilities.Health care leaders and clinicians should recognize the racial disparities that racially minoritized youth with physical disabilities encounter in accessing or receiving care in addition to health outcomes.Health care leaders and decision-makers should advocate for policy change to optimize equitable and inclusive health care to enhance the well-being of racially minoritized children with disabilities.Health care providers should engage in training to understand how to recognize and address how intersectional forms of a child's identity such as disability, race, and socio-economic status can influence health care experiences and health outcomes.
属于种族少数群体的儿童和青少年通常会经历多种复杂形式的歧视和健康差距。本综述的目的是探讨身体残疾儿童和青少年在医疗保健和健康结果方面的种族差异。
检索并筛选了六个国际数据库（Ovid Medline、Healthstar、Embase、PsycINFO、Scopus和Web of Science）以纳入研究。采用叙述性综合分析来确定共同趋势。
37篇文章符合纳入标准，涉及218555名患有各种身体残疾的儿童和青少年，时间跨度超过29年。我们注意到以下趋势：（1）在获得或接受护理方面的种族差异；（2）健康结果和死亡率方面的种族差异；（3）影响种族差异的因素。大多数研究报告了至少一项发现，表明与白人青少年相比，种族少数群体的青少年在获得护理方面存在差异和/或在健康结果方面存在差距。
我们的研究结果凸显了身体残疾儿童和青少年在医疗保健方面令人担忧的种族差异。迫切需要在多个层面进行宣传和干预，以解决身体残疾的种族少数群体青少年所经历的长期存在的种族主义和种族差异问题。
对康复的启示
医疗保健领导者和医疗保健提供者迫切需要解决身体残疾的种族少数群体儿童和青少年在康复方面存在的系统性健康不平等问题。
医疗保健领导者和临床医生除了要认识到身体残疾的种族少数群体青少年在健康结果方面存在的种族差异外，还应认识到他们在获得或接受护理方面所遇到的种族差异。
医疗保健领导者和决策者应倡导政策变革，以优化公平和包容的医疗保健，增进身体残疾的种族少数群体儿童的福祉。
医疗保健提供者应参与培训，以了解如何认识和解决儿童身份的交叉形式（如残疾、种族和社会经济地位）如何影响医疗保健体验和健康结果。
