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Primary language of parent is associated with disparities in pediatric preventive care
Adam L Cohen1, Dimitri A Christakis
1Department of Pediatrics, Child Health Institute, and Children's Hospital and Regional Medical Center, University of Washington, Seattle, WA, USA. alcohen@u.washington.edu
Insights
Infants whose parents speak a primary language other than English are half as likely to receive recommended preventive care. This study highlights disparities in pediatric preventive care access for non-English speaking families.
Area of Science:
- Pediatric Health Services Research
- Health Disparities
- Public Health Policy
Background:
- Access to recommended pediatric preventive care is crucial for infant health and development.
- Language barriers may impede effective communication between healthcare providers and families, potentially affecting care utilization.
- Previous research indicates disparities in healthcare access among minority populations, but specific impacts of primary language require further investigation.
Purpose of the Study:
- To investigate whether infants of parents whose primary language is not English are less likely to receive recommended preventive care compared to infants of English-speaking parents.
- To quantify the association between parental primary language and the receipt of timely and appropriate pediatric preventive care visits.
- To identify specific demographic groups affected by these disparities.
Main Methods:
- A retrospective cohort study was conducted using Washington state Medicaid data for 38,793 1-year-old infants born between 1999 and 2000.
- Parental primary language was the main exposure variable, categorized as English or non-English.
- Multivariate regression analysis was used to estimate the relative risk of receiving recommended preventive care visits in the first year of life.
Main Results:
- Only 15.4% of infants received all six recommended preventive care visits within their first year.
- Infants of parents whose primary language was not English were significantly less likely to receive all recommended visits (adjusted relative risk = 0.53; 95% CI, 0.49-0.58).
- This disparity was observed across white, Hispanic, and African-American infants, but not in Asian-American infants.
Conclusions:
- Significant disparities in the receipt of recommended pediatric preventive care exist based on parental primary language.
- These disparities disproportionately affect white, Hispanic, and African-American infants enrolled in Medicaid.
- Addressing language barriers is essential to ensure equitable access to crucial preventive healthcare services for all infants.
Objectives:
To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English.
Study Design:
We conducted a retrospective cohort study of all 38,793 1-year-old Medicaid-enrolled infants born in Washington state between January 1, 1999 and September 30, 2000. The main exposure was self-reported primary language of parents. Using multivariate regression, we estimated the relative risk of receiving appropriate and timely receipt of preventive care visits in the first year as recommended by the American Academy of Pediatrics and Washington state Medicaid.
Results:
Fewer than 1 in 6 (15.4%) infants received all 6 recommended preventive care visits in their first year of life. Infants of parents whose primary language was not English were half as likely to receive all recommended preventive care visits compared with infants of parents whose primary language was English (adjusted relative risk = 0.53; 95% confidence interval = 0.49 to 0.58). This disparity was seen in white, Hispanic, and African-American infants, but not in Asian-American infants.
Conclusions:
Disparities based on primary language exist in receipt of recommended pediatric preventive care in white, Hispanic, and African-American infants enrolled in Medicaid.
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