Bui Anthony L, Ball Alexis M, Ko Linda K, Ng Marie, Rivara Frederick P, Coker Tumaini R
Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Research Institute, Seattle, Washington.
Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Research Institute, Seattle, Washington.
Am J Prev Med. 2025 Aug;69(2):107644. doi: 10.1016/j.amepre.2025.107644. Epub 2025 May 6.
Given the youth mental health crisis, this study examines racial and ethnic disparities of foregone preventive care, unmet mental healthcare needs, and difficulty accessing mental healthcare among youth with common mental health problems.
A cross-sectional analysis was conducted using the 2022 National Survey of Children's Health (NSCH), examining U.S. youth aged 8-17 years with parent-reported anxiety, depression, or behavioral problems. NSCH survey weights were utilized, and ORs were estimated for each racial and ethnic group across foregone preventive care, unmet mental healthcare needs, and difficulty obtaining mental healthcare, adjusting for age, sex, language, income, parental education, and insurance.
Among the weighted sample of 6,608 youth with common mental health problems, 14.2% of children with common mental health problems had forgone preventive care, 15.1% had unmet mental healthcare needs, and 59.2% had difficulty obtaining mental healthcare. Per parental report, Black children had 1.59 (95% CI=1.01, 2.51) times the odds of foregoing preventive care in the past year compared to White children. Asian children had 2.32 (1.18, 4.48) times the odds of unmet mental healthcare compared to White children. There were no significant differences in difficulty obtaining mental healthcare across race and ethnicity.
Racial and ethnic disparities exist in accessing preventive and mental healthcare among children with parent-reported mental health conditions. Black youth have higher rates of foregone preventive care, while Asian youth have higher unmet mental healthcare needs compared to White youth. Further research should explore barriers and facilitators of collaborative care to reduce youth mental healthcare disparities.
鉴于青少年心理健康危机，本研究调查了患有常见心理健康问题的青少年在放弃预防性保健、未满足的心理保健需求以及获得心理保健困难方面的种族和族裔差异。
使用2022年全国儿童健康调查（NSCH）进行横断面分析，调查美国8至17岁有家长报告存在焦虑、抑郁或行为问题的青少年。采用NSCH调查权重，并估计每个种族和族裔群体在放弃预防性保健、未满足的心理保健需求以及获得心理保健困难方面的比值比（OR），同时对年龄、性别、语言、收入、父母教育程度和保险进行调整。
在加权后的6608名患有常见心理健康问题的青少年样本中，14.2%患有常见心理健康问题的儿童放弃了预防性保健，15.1%有未满足的心理保健需求，59.2%在获得心理保健方面存在困难。根据家长报告，与白人儿童相比，黑人儿童在过去一年中放弃预防性保健的几率是白人儿童的1.59倍（95%置信区间=1.01，2.51）。与白人儿童相比，亚裔儿童未满足心理保健需求的几率是白人儿童的2.32倍（1.18，4.48）。在获得心理保健困难方面，不同种族和族裔之间没有显著差异。
在有家长报告心理健康状况的儿童中，在获得预防性和心理保健方面存在种族和族裔差异。与白人青少年相比，黑人青少年放弃预防性保健的比例更高，而亚裔青少年未满足的心理保健需求更高。进一步的研究应探索协作护理的障碍和促进因素，以减少青少年心理保健差异。
