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Racial disparities in pediatric intensive care unit admissions
Dawn Turner1, Pippa Simpson, Shun-Hwa Li
1Division of Pediatric Critical Care, University of Kentucky College of Medicine, KY, USA.
Insights
African American children face a higher risk of admission to the pediatric intensive care unit (PICU). This study found racial disparities in PICU admissions, highlighting a critical area for further research.
Area of Science:
- Pediatric critical care medicine
- Health services research
- Racial disparities in healthcare
Background:
- Racial disparities in adult and neonatal intensive care units are established.
- Limited data exists on racial disparities within pediatric intensive care units (PICUs).
Purpose of the Study:
- To investigate potential racial disparities in the admission rates of critically ill children to the PICU.
- To determine if African American children are admitted to the PICU at different rates than non-Hispanic white children.
Main Methods:
- Retrospective analysis of PICU admissions at a tertiary care pediatric hospital.
- Demographic data analyzed from county health department records.
- Study period: January 1, 1997, to December 31, 1999.
Main Results:
- African American children constituted 76.6% of admissions for children under 48 months in Shelby County, TN, compared to 58% of the county population.
- A history of premature birth was more prevalent in African American children (46.8%) versus non-Hispanic white children (32.8%).
- African American children had a 2.12 times higher relative risk of PICU admission compared to non-Hispanic white children.
Conclusions:
- Significant racial differences exist in PICU admissions.
- African American children demonstrate an elevated risk for PICU admission compared to non-Hispanic white children.
- Findings underscore the need to address racial disparities in pediatric critical care access.
Objectives:
Racial disparities in therapies and outcomes in adult and neonatal ICUs are well documented; however, little is known regarding racial disparities in pediatric intensive care unit (PICU). Our objective was to determine whether racial disparities exist in the admission of critically ill children to the PICU.
Methods:
We retrospectively analyzed admissions to a PICU in a tertiary care pediatric hospital. Summarized demographic data was analyzed from the county health department.
Results:
Of the 4676 admissions to the PICU between January 1, 1997 and December 31, 1999, 1030 children were <48 months of age, lived in Shelby County, TN, and were either African American (789, 76.6%) or non-Hispanic white (241, 23.4%). The surrounding county was comprised of approximately 58% African American and 41% non-Hispanic white children ≤ 48 months of age. A history of premature birth was more common in African American children than non-Hispanic white children (46.8% vs. 32.8%; P < 0.0001). Mortality was 5.7% overall and was not significantly different between African Americans and non-Hispanic whites but was higher for those children with a history of premature birth (4.6% vs. 7.1%, P < 0.026). The overall relative risk of admission to the PICU for African American children was 2.12 (95% CI, 1.66-2.74), for African American children with a history of premature birth was 1.44 (95% CI, 0.96-2.21), and for full-term African American children was 1.82 (95% CI, 1.33 -2.49).
Conclusions:
Racial differences in admission to the PICU exist with African American children having a greater risk for PICU admission than non-Hispanic white children.
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