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National Healthcare Disparities Report, 2004

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Quality of Health Care

Vaccinations. Childhood vaccinations protect recipients from illness and disability and others in the community who cannot be vaccinated, such as small children and people who are immunosuppressed. They are important for reducing mortality and morbidity in populations.

Figure 4.18. Children age 19-35 months who received all recommended vaccines by race (top), ethnicity (middle), and income (bottom), 2000-2002

Figure 4.18. Children age 19-35 months who received all recommended vaccines by race, 2000-2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.18. Children age 19-35 months who received all recommended vaccines by ethnicity, 2000-2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.18. Children age 19-35 months who received all recommended vaccines by income, 2000-2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: National Immunization Survey, 2000-2002.

Reference population: Civilian noninstitutionalized population age 19-35 months.

Note: Recommended vaccines for children 19-35 months include 4 doses of DTaP vaccine, 3 doses of polio vaccine, 1 dose of MMR vaccine, 3 doses of H. influenzae type B vaccine, and 3 doses of hepatitis B vaccine. For results related to individual childhood immunizations, go to Tables 2.6a and 2.6b.

  • In all 3 years, the proportion of children who received all recommended vaccines was lower among black compared with white children; Hispanic compared with non-Hispanic white children; and poor, near poor, and middle income compared with high income children (Figure 4.18).
  • Between 2000 and 2002, vaccination improved among Asian, Hispanic, and high income children.

Figure 4.19. Children age 19-35 months who received all recommended vaccines by race (top) and ethnicity (bottom) stratified by family income, 2002

Figure 4.19. Children age 19-35 months who received all recommended vaccines by race stratified by family income, 2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.19. Children age 19-35 months who received all recommended vaccines by ethnicity stratified by family income, 2002. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: National Immunization Survey, 2002.

Reference population: Civilian noninstitutionalized population age 19-35 months.

Note: Recommended vaccines for children 19-35 months include 4 doses of DTaP vaccine, 3 doses of polio vaccine, 1 dose of MMR vaccine, 3 doses of H. influenzae type B vaccine, and 3 doses of hepatitis B vaccine.

  • Only high income whites, Asians, and non-Hispanic whites achieved the HP2010 goal of 80% of children receiving all recommended vaccines (Figure 4.19).

Obesity and overweight. Childhood obesity is a risk factor for diabetes, hypertension, and high cholesterol61. In the past 20 years, the prevalence of overweight (defined as age-gender specific body mass index at 95th percentile or higher) among children ages 6-11 has doubled, and the prevalence among adolescents ages 12-19 has tripled. In 1999-2000, 27% of Mexican boys and 18% of non-Hispanic black boys were overweight compared with 16% of boys ages 6-11 overall; 20% of Mexican girls and 22% of non-Hispanic black girls were overweight compared with 15% of girls overall48. Lack of physical activity is a major contributor to childhood obesity, and routine promotion of physical activity among young people is recommended62.

Figure 4.20. Children ages 2 to 17 whose parents reported advice from a doctor or other health provider about amount and kind of physical activity by race, ethnicity, and income, 2001

Figure 4.20. Children ages 2 to 17 whose parents reported advice from a doctor or other health provider about amount and kind of physical activity by race, ethnicity, and income, 2001. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: Medical Expenditure Panel Survey, 2001.

Reference population: Civilian noninstitutionalized population age 2-17.

  • In 2001, the proportion of parents with children 2 to 17 who had advice from a doctor or other health provider about amount and kind of physical activity was higher among parents of children with special health care needs (Figure 4.20).
  • Among both CSHCN and other children, report of advice about physical activity was lower among parents of poor and near poor compared with high income children. Racial and ethnic differences were not significant.

Asthma. Asthma is one of the most prevalent chronic diseases affecting children. In 2002, 8.6% of black and 5.2% of white children and 8% of poor and 5.5% of non-poor children had an asthma attack63. Good asthma management, including anti-inflammatory medicine and a written action plan, can prevent asthma attacks and reduce use of emergency rooms and hospitals.

Figure 4.21. Hospital admissions for asthma per 10,000 children by race, 1998-2001

Figure 4.21. Hospital admissions for asthma per 10,000 children by race, 1998-2001. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: National Hospital Discharge Survey, 1998-2001.

Reference population: Children age 0-17.

  • In all 4 years, rates of hospital admissions for asthma were higher among black children than white children (Figure 4.21).
  • Between 1998 and 2001, rates of hospitalization for asthma did not change significantly among black or white children.

Patient safety. Measures of patient safety tracked in the NHDR are part of AHRQ's Patient Safety Indicators64. Birth trauma counts injuries to full-term infants born alive in the hospital.

Figure 4.22. Birth trauma injury per 1,000 live births by race/ethnicity (top) and area income (bottom), 2001

Figure 4.22. Birth trauma injury per 1,000 live births by race/ethnicity, 2001. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Figure 4.22. Birth trauma injury per 1,000 live births by area income, 2001. Select Full Text Description [D] for details.

[D] Select for Full Text Description.

Source: HCUP State Inpatient Databases disparities analysis file, 2001.

Reference population: Live births.

Note: White, Black, and API are non-Hispanic groups.

  • In 2001, rates of birth trauma were lower among Hispanic compared with non-Hispanic white children and among residents of poorer ZIP Codes compared with residents of ZIP Codes with income of $45,000 and over (Figure 4.22). Black-white differences were not significant.

 

 

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