Table 4.
Multivariable Analysis of Racial/Ethnic Disparities in Medical and Oral Health Status, Access to Care, and Use of Services among U.S. Adolescents
| Odds Ratio (95% Confidence Interval) versus White Adolescents | |||||
|---|---|---|---|---|---|
| Outcome | Latino | African American | Asian/Pacific Islander | American Indian/Alaska Native | Multiracial |
| Medical and oral health status | |||||
| Health not excellent/very good | 2.12 (1.78, 2.52) | 2.08 (1.80, 2.39) | NS | NS | NS |
| Overweight or obese | 1.36 (1.16, 1.59) | 1.74 (1.56, 1.94) | NS | 1.83 (1.27, 2.64) | NS |
| Asthma | 1.33 (1.10, 1.60) | 1.40 (1.22, 1.61) | NS | 1.62 (1.09, 2.40) | NS |
| Diabetes | NS | 0.42 (0.23, 0.75) | 0.03 (0.00, 0.22) | NS | NS |
| Hearing/vision problems | NS | 0.51 (0.37, 0.71) | 0.31 (0.13, 0.70) | 2.10 (1.18, 3.71) | NS |
| Bone/joint/muscle problems | NS | NS | 0.32 (0.16, 0.66) | NS | NS |
| Digestive allergies | NS | NS | NS | NS | NS |
| Skin allergies | NS | 1.89 (1.62, 2.22) | NS | 1.77 (1.10, 2.86) | 1.36 (1.04, 1.78) |
| ≥3 ear infections in past year | NS | 0.64 (0.45, 0.91) | 0.10 (0.03, 0.35) | NS | NS |
| Needs more medical care than others | NS | 0.74 (0.64, 0.87) | 0.32 (0.19, 0.56) | NS | NS |
| Has limited abilities | NS | NS | NS | 2.50 (1.55, 4.03) | NS |
| Needs/gets special therapy | NS | NS | 0.41 (0.19, 0.88) | NS | NS |
| Behavior problems | NS | NS | NS | NS | NS |
| Developmental delay | NS | 0.58 (0.43, 0.78) | NS | NS | NS |
| Speech problems | NS | NS | NS | NS | NS |
| Difficulty with emotions, concentration, behavior, or interpersonal relations | NS | 1.21 (1.07, 1.37) | 0.49 (0.29, 0.83) | NS | 1.32 (1.06, 1.65) |
| Emotional, developmental, or behavioral problems needing treatment or counseling | NS | 0.80 (0.65, 0.97) | NS | NS | NS |
| Depression/anxiety | NS | 0.52 (0.41, 0.67) | 0.36 (0.15, 0.84) | NS | NS |
| Learning disability | NS | 0.85 (0.72, 1.00) | 0.38 (0.22, 0.65) | NS | NS |
| ADHD | 0.69 (0.54, 0.89) | 0.67 (0.56, 0.81) | NS | NS | NS |
| Teeth condition not excellent/very good* | 1.59 (1.37, 1.85) | 1.75 (1.56, 1.95) | NS | NS | 1.23 (1.01,1.50) |
| Access to medical and dental care | |||||
| No health insurance† | 1.47 (1.18, 1.83) | 1.30 (1.04, 1.63) | NS | 1.74 (1.14, 2.66) | NS |
| Sporadically insured in past year† | 1.36 (1.07, 1.73) | 1.47 (1.23, 1.75) | NS | 1.67 (1.17, 2.38) | NS |
| No dental insurance† | NS | 0.78 (0.68, 0.91) | NS | 1.49 (1.10, 2.02) | NS |
| No PDN | 1.65(1.38, 1.98) | 2.00 (1.75, 2.29) | NS | 2.52 (1.77, 3.58) | 1.62 (1.28, 2.06) |
| Did not receive all needed medical care‡ | NS | 2.15 (1.14, 4.07) | NS | 5.36 (2.00, 14.41) | 3.72 (1.93, 7.19) |
| Reason for unmet medical care need | |||||
| Health-plan problem | NS | NS | 26.61 (2.47, 286.47) | NS | 8.40 (2.39,29.56) |
| No one accepts child's insurance | NS | NS | NE | NS | NS |
| No insurance | NS | NS | NS | 0.18 (0.04, 0.91) | 0.15 (0.05, 0.44) |
| Cost | NS | 0.36 (0.15, 0.86) | NS | NS | NS |
| Transportation | NS | NS | NE | 8.38 (1.28, 54.82) | NS |
| Treatment is ongoing | 11.58 (1.96,68.34) | NS | NE | 11.92(1.24, 115.07) | NS |
| Problems getting specialty care | 1.57 (1.12, 2.20) | NS | 3.17 (1.72, 5.82) | 3.19 (1.39, 7.34) | NS |
| Did not receive all needed prescription medications in past year | NS | 1.88 (1.26, 2.78) | NS | NS | NS |
| Did not receive all needed dental care§ | NS | 1.70 (1.23, 2.35) | NS | NS | 1.89 (1.14, 3.12) |
| Reason for unmet dental care needd | |||||
| Transportation | NS | NS | 16.09 (1.58, 163.51) | 7.99 (2.24, 28.52) | 0.18 (0.04, 0.95) |
| Dentist did not know how to provide care | NS | NS | NE | NE | NS |
| No one accepts child's insurance | NS | NS | NE | NS | 0.12 (0.02, 0.66) |
| Inconvenient times/could not get an appointment | NS | NS | 13.20 (1.34, 129.49) | 6.72 (2.12, 21.26) | NS |
| No dental insurance | NS | NS | NS | NS | NS |
| Cost | NS | 0.50 (0.32, 0.80) | 0.11 (0.02, 0.67) | 0.19 (0.06, 0.65) | NS |
| Treatment is ongoing | NS | NS | NE | 5.49 (1.27, 23.76) | NS |
| Use of medical and dental services | |||||
| No physician visit in past year | NS | 1.28 (1.11, 1.46) | 2.32 (1.54, 3.51) | 1.77 (1.16, 2.69) | NS |
| One or more ED visits in past year | NS | NS | 0.45 (0.28, 0.73) | NS | NS |
| Received no mental health care in past year | NS | 1.90 (1.57, 2.30) | 2.36 (1.21, 4.61) | NS | NS |
| No routine preventive dental visit in past year§ | NS | 2.42 (1.97, 2.96) | 2.43 (1.19, 4.97) | 2.67 (1.68, 4.27) | 1.57 (1.07, 2.30) |
| Received no mental health care in past year | NS | 1.90 (1.57, 2.30) | 2.36 (1.21, 4.61) | NS | NS |
| Needs/uses prescription medication | NS | 0.78 (0.69, 0.88) | 0.61 (0.39, 0.94) | NS | NS |
| Not given prescription medication in past year | 1.35 (1.15, 1.59) | 1.85 (1.63, 2.10) | 3.06 (2.08, 4.50) | NS | 1.33 (1.07, 1.66) |
Note. Adjusted for primary language spoken at home, child's age and medical insurance coverage, highest educational attainment and employment status of adult in household, number of children in the household, number of adults in the household, and poverty level.
Adjusted for dental, rather than medical, insurance coverage, as well as child's age, highest educational attainment and employment status of adult in household, number of children and adults in the household, and poverty status.
Adjusted for primary language spoken at home, child's age, highest educational attainment and employment status of adult in household, number of children in the household, number of adults in the household, and poverty level.
Only if made a physician visit in past 12 months.
Only for those making a dental visit in past 12 months; adjusted for primary language spoken at home, child's age and dental insurance coverage, educational attainment and employment status of an adult in household, number of children in the household, number of adults in the household, and poverty level.
NS, nonsignificiant; NE, nonestimable.
Source. National Survey of Childhood Health.