Health Disparities Persist Among Children: Opportunities for the ACA – Say Ahhh! A Children’s Health Policy Blog

While Minority Health Month draws to a close this week,
the just released “National Healthcare Disparities Report,” from the
Agency for Health Care Quality illustrates the urgency for dedicating more
attention to the issue. Mandated by Congress, the 2011 report is the ninth to
be issued.  Overall, the report
finds that access to health care did not improve for most racial and ethnic groups
from 2002 through 2008. Below, I highlight some findings specific to racial and
ethnic disparities in child and maternal health.

Infant mortality rates, often considered a good indicator
of the overall health of a nation, gives reason for pause.  The 2009 data indicate that African
American infants had the highest infant mortality rate at 267 per 1,000 live
births compared to the rates of all other racial/ethnic groups and to the
national average (245 deaths per 1,000 births). Comparing the rate of
maternal deaths, the gap between African American and White women has continued
to grow larger.

One of the new measures added in 2011 to track the
effectiveness of care is the percentage of children ages 0-17 who received a
wellness check-up in the past 12 months.  Using 2009 data, the most recent that is available, the
report indicates slightly more promising results for African American children,
who received wellness check-ups at the highest rate, 83.5 percent, compared to
both the national average (77.9 percent) and children of all other
races/ethnicities. American Indians and Alaskan Natives received wellness
visits at a rate lower than any other racial group -71.8 percent – and
Hispanics had a lower rate than non-Hispanics, 74.9 versus 78.8 percent.

Overall, there was little difference in the percentage of
children who had a wellness visit within the last 12 months based on private or
public insurance, 80.8 percent versus 80.5 percent.  Yet, it is noteworthy that children of most racial and
ethnic groups with public health insurance coverage were more likely to have
had a wellness visit when compared to the average for their racial or ethnic
group.  The increase was most
dramatic for Hispanics, American Indians, and children of multiple races – each
group’s rate increased by at least four percentage points: 79.3, 76.9, and
84.2, respectively.

Immunizations are another crucial aspect of preventative
care, but in 2009, the national average of children ages 19-35 months who
received all of their recommended vaccines was only 63.6 percent.  White children received vaccinations at
the highest rate of any racial group, 65.3 percent, followed by 62.3 percent of
Asian children, 61.9 percent of American Indian and Alaskan Native children, 58.5
percent of African American children and 56.9 of multi-racial children. Native
Hawaiian and Pacific Islander children had the lowest rate, with just 53.7
percent. Hispanics children received all recommended immunizations at a higher
rate when compared to non-Hispanics, 67.1 versus 62.2 percent.

It is important to remember that the data contained in
this report predates the passage of the Affordable Care Act, which contains
many provisions to reduce barriers to care.  HHS used those provisions as the basis for its Action Plan
to Reduce Health Disparities
among racial and ethnic minorities.  As my colleagues pointed out last
month, the ACA is already helping to maintain or improve access to preventative
services for more than half of America’s children.  The data is not disaggregated by race
and ethnicity, but the ACA equirement to improve the collection of
demographic data presents us with another opportunity to tackle the question of
where health disparities remain.

Scroll to Top