title: Children with cerebral palsy:  racial disparities in functional limitations.
abstract: BACKGROUND
  Previous studies of the frequency of cerebral palsy in the United States have found excess prevalence in black children relative to other groups. Whether the severity of cerebral palsy differs between black and white children has not previously been investigated.
  
  
  METHODS
  A population-based surveillance system in 4 regions of the United States identified 476 children with cerebral palsy among 142,338 8-year-old children in 2006. Motor function was rated by the Gross Motor Function Classification System and grouped into 3 categories of severity. We used multiple imputation to account for missing information on motor function and calculated the race-specific prevalence of each cerebral palsy severity level.
  
  
  RESULTS
  The prevalence of cerebral palsy was 3.7 per 1000 black children and 3.2 per 1000 white children (prevalence odds ratio [OR] = 1.2 [95% confidence interval = 1.0-1.4]). When stratified by severity of functional limitation, the racial disparity was present only for severe cerebral palsy (black vs. white prevalence OR=1.7 [1.1-2.4]). The excess prevalence of severe cerebral palsy in black children was evident in term and very preterm birth strata.
  
  
  CONCLUSIONS
  Black children in the United States appear to have a higher prevalence of cerebral palsy overall than white children, although the excess prevalence of cerebral palsy in black children is seen only among those with the most severe limitations. Further research is needed to explore reasons for this disparity in functional limitations; potential mechanisms include racial differences in risk factors, access to interventions, and under-identification of mild cerebral palsy in black children.
authors.affiliation: Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA. mjmaenner@wisc.edu
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Maenner
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Benedict
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Arneson
authors.forename: Marshalyn
authors.initials: M
authors.lastname: Yeargin-Allsopp
authors.forename: Martha S
authors.initials: MS
authors.lastname: Wingate
authors.forename: Russell S
authors.initials: RS
authors.lastname: Kirby
authors.forename: Kim
authors.initials: K
authors.lastname: Van Naarden Braun
authors.forename: Maureen S
authors.initials: MS
authors.lastname: Durkin
mesh_terms: D000203:Activities of Daily Living; D044383:Black People / Q000706:statistics & numerical data; D002547:Cerebral Palsy / Q000453:epidemiology*; D002648:Child; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American