Pediatric otolaryngologic conditions: Racial and socioeconomic disparities in the United States.
Determine the national incidence and disparities for common pediatric otolaryngologic conditions.



Cross-sectional analysis of a nationally representative database.



The National Health Interview Survey (2012) was analyzed, extracting children with frequent ear infections (FEI), nonstreptococcal sore throat (NSST), streptococcal pharyngitis (SP), hay fever, and sinusitis. Demographic data including age, sex, race, Hispanic ethnicity, geographic region, poverty level, and insurance status were extracted. The annual incidences of these conditions were determined. Disparities in the incidence of each condition was determined according to race and ethnicity, adjusting for other demographic variables.



Among 73.3 million children (average age, 8.6 years; 51.1% male), the incidences were: FEI (4.0 million, 5.5% of children), NSST (11.9 million, 20.6% of children), SP (8.0 million, 13.8% of children), hay fever (6.6 million, 9.0% of children), and sinusitis (4.5 million, 7.9% of children). Black and Hispanic children were less likely to be diagnosed with FEI than white children (odds ratio: 0.503 [95% confidence interval: 0.369-0.686] and odds ratio: 0.661 [95% confidence interval: 0.515-0.848]), adjusting for all other demographic variables. Black and Hispanic children were also less likely to be diagnosed with SP than white children (odds ratio: 0.433 [95% confidence interval: 0.342-0.547] and odds ratio: 0.487 [95% confidence interval: 0.401-0.592], respectively). Similar decreased odds ratios for black and Hispanic children were evident for hay fever (odds ratio: 0.704 [95% confidence interval: 0.556-0.890] and odds ratio: 0.708 [95% confidence interval: 0.565-0.888], respectively) and for sinusitis (odds ratio: 0.701 [95% confidence interval: 0.543-0.905] and odds ratio: 0.596 [95% confidence interval:0.459-0.773], respectively).



Black and Hispanic children are consistently less likely to be identified or diagnosed with FEI, hay fever, SP, and sinusitis compared to white children. These data likely highlight a significant health care disparity according to race/ethnicity in otolaryngology.



2b Laryngoscope, 127:746-752, 2017.
Department of Head and Neck Surgery, University of California-Los Angeles, David Geffen School of Medicine, Los Angeles, California, U.S.A.
Sophie
S
Shay
Department of Head and Neck Surgery, University of California-Los Angeles, David Geffen School of Medicine, Los Angeles, California, U.S.A.
Nina L
NL
Shapiro
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Neil
N
Bhattacharyya
D000208:Acute Disease; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D019458:Insurance Coverage / Q000639:trends*; D008297:Male; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D044469:Racial Groups / Q000706:statistics & numerical data*; D018570:Risk Assessment; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States
Pediatric; ear infections; hay fever; health care disparities; pediatric general; pharyngitis; race; sinusitis; socioeconomic; streptococcal