TY - JOUR
T1 - Linguistic Disparities in Child Health and Presence of a Medical Home Among United States Latino Children
AU - Cordova-Ramos, Erika G.
AU - Tripodis, Yorghos
AU - Garg, Arvin
AU - Kalluri, Nikita S.
AU - Flores, Glenn
AU - Parker, Margaret G.
N1 - Funding Information:
Financial statement: This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through BU-CTSI Grant Number 1UL1TR001430. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2021 Academic Pediatric Association
PY - 2022
Y1 - 2022
N2 - Objective: The impact of household language on Latino-White and Latino intragroup disparities in child health and having a medical home in the United States is poorly understood. This study aimed to examine these disparities 1) between Whites and Latinos (overall and stratified by English-primary-language [EPL] and non-English-primary-language [NEPL] households); 2) within Latinos, stratified by household language; and 3) potential moderation of disparities by social determinants. Methods: Cross-sectional analysis of nationally representative sample of children 0 to 17 years old from the 2016–2018 National Survey of Children's Health. We evaluated associations of child race/ethnicity and household language with child health and presence of a medical home. Multivariable logistic regression was used to compare groups of interest, adjusting for sociodemographic factors and health needs. Moderation was assessed using interaction terms for household income, parental educational attainment, and child insurance coverage. Results: Among 81,514 children, 13.5% were NEPL Latino, and 19.4% were EPL Latino. Compared with EPL Whites, both EPL and NEPL Latinos had reduced odds of excellent/very good health (adjusted odds ratio [aOR]: 0.70; 95% confidence interval [CI]: 0.58–0.84; and aOR: 0.42; 95% CI: 0.33–0.53) and presence of a medical home (aOR: 0.62; 95% CI: 0.56–0.69; and aOR: 0.45; 95% CI: 0.37–0.54), respectively. Among Latinos, NEPL (vs EPL) was also associated with reduced odds of excellent/very good health (aOR: 0.61; 95% CI: 0.46–0.83), and presence of a medical home (aOR: 0.66; 95% CI: 0.48–0.78); these associations were magnified by adverse social determinants. Conclusions: Striking Latino-White and within-Latino medical-home disparities persist in the United States, particularly for NEPL Latino children. Interventions should target social determinants and the rich sociocultural and linguistic diversity of the Latino population.
AB - Objective: The impact of household language on Latino-White and Latino intragroup disparities in child health and having a medical home in the United States is poorly understood. This study aimed to examine these disparities 1) between Whites and Latinos (overall and stratified by English-primary-language [EPL] and non-English-primary-language [NEPL] households); 2) within Latinos, stratified by household language; and 3) potential moderation of disparities by social determinants. Methods: Cross-sectional analysis of nationally representative sample of children 0 to 17 years old from the 2016–2018 National Survey of Children's Health. We evaluated associations of child race/ethnicity and household language with child health and presence of a medical home. Multivariable logistic regression was used to compare groups of interest, adjusting for sociodemographic factors and health needs. Moderation was assessed using interaction terms for household income, parental educational attainment, and child insurance coverage. Results: Among 81,514 children, 13.5% were NEPL Latino, and 19.4% were EPL Latino. Compared with EPL Whites, both EPL and NEPL Latinos had reduced odds of excellent/very good health (adjusted odds ratio [aOR]: 0.70; 95% confidence interval [CI]: 0.58–0.84; and aOR: 0.42; 95% CI: 0.33–0.53) and presence of a medical home (aOR: 0.62; 95% CI: 0.56–0.69; and aOR: 0.45; 95% CI: 0.37–0.54), respectively. Among Latinos, NEPL (vs EPL) was also associated with reduced odds of excellent/very good health (aOR: 0.61; 95% CI: 0.46–0.83), and presence of a medical home (aOR: 0.66; 95% CI: 0.48–0.78); these associations were magnified by adverse social determinants. Conclusions: Striking Latino-White and within-Latino medical-home disparities persist in the United States, particularly for NEPL Latino children. Interventions should target social determinants and the rich sociocultural and linguistic diversity of the Latino population.
KW - health care disparities
KW - Latino child health
KW - medical home
KW - primary household language
KW - social determinants of health
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U2 - 10.1016/j.acap.2021.09.011
DO - 10.1016/j.acap.2021.09.011
M3 - Article
C2 - 34571252
AN - SCOPUS:85124155848
JO - Academic Pediatrics
JF - Academic Pediatrics
SN - 1876-2859
ER -
