title: Black/white differential use of health services by young children in a rural Mississippi community.
abstract: OBJECTIVE
  Use of health services in rural communities has not been well studied. We explored how black and white children used health services in a rural Mississippi community.
  
  
  METHODS
  Data were prospectively collected for 396 children attending a private practice to determine if race was associated with the use of health services in this community.
  
  
  RESULTS
  White children made more sick contacts than black children (P < 0.001). Black children (36%) were more likely to be treated in the emergency room than white children (24%; P = 0.013). There was no black-white difference in the hospitalization rates, although white children were more likely to undergo ear-nose-throat (ENT) surgery for pressure equalizing tube (PET) placement, and/or tonsillectomy and adenoidectomy (T and A; P < 0.001). Even after controlling for various confounders, the frequency of all physician sick contacts was twice as high for white children than for black children (RR = 2.17; 95% C.I. = 1.32-3.58).
  
  
  CONCLUSIONS
  Overall, black children used disproportionately fewer health services than their white counterparts, but used significantly higher emergency room services. Private insurance coverage was the single most significant variable that accounted for the black-white differential use of the emergency room.
authors.affiliation: Children's Clinic of Clarksdale, Clarksdale, MS, USA. pkumnji@vcu.edu
authors.forename: Philip
authors.initials: P
authors.lastname: Kum-Nji
authors.forename: Carole L
authors.initials: CL
authors.lastname: Mangrem
authors.forename: Peggy J
authors.initials: PJ
authors.lastname: Wells
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Klesges
authors.forename: Henry G
authors.initials: HG
authors.lastname: Herrod
mesh_terms: D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D002662:Child Health Services / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008922:Mississippi; D009819:Office Visits / Q000706:statistics & numerical data*; D011446:Prospective Studies; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American