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Chronic rhinosinusitis in children: race and socioeconomic status
David F Smith1, Stacey L Ishman, David E Tunkel
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Children with chronic rhinosinusitis (CRS) are more likely to be white and privately insured compared to the general pediatric otolaryngology population. This study highlights demographic disparities in pediatric CRS diagnosis and treatment.
Area of Science:
- Pediatric Otolaryngology
- Epidemiology of Chronic Diseases
- Health Disparities
Background:
- Chronic rhinosinusitis (CRS) is a prevalent condition in children.
- Limited research exists on the impact of race and socioeconomic status (SES) on pediatric CRS diagnosis and treatment.
- Understanding demographic factors is crucial for equitable healthcare delivery.
Purpose of the Study:
- To describe the epidemiology of children diagnosed with CRS in a pediatric otolaryngology clinic.
- To evaluate demographic differences, specifically race and SES, in children with CRS compared to a general pediatric otolaryngology patient group.
- To identify potential disparities in the diagnosis and treatment of pediatric CRS.
Main Methods:
- Historical cohort study conducted at a tertiary academic care center.
- Comparison of new/consult patients with CRS (n=174) to a control group (n=430) seen in the same clinic.
- Analysis of patient records for age, sex, race, and insurance status, with statistical comparisons using Mann-Whitney and Fisher's exact tests.
Main Results:
- Children with CRS were older (8.2 years) and more frequently male compared to controls.
- Children with CRS were significantly more likely to be white (77% vs. 47%) and less likely to have medical assistance (14% vs. 44%).
- A higher proportion of children with CRS had private insurance compared to the control group.
Conclusions:
- In this academic urban setting, children with CRS were disproportionately white and privately insured.
- This study is the first to investigate race and SES in relation to pediatric CRS.
- Further research using nationally representative data is recommended to confirm these demographic variations in pediatric CRS.
Purpose:
Although chronic rhinosinusitis (CRS) is common in children, the influence of race and socioeconomic status (SES) on the diagnosis/treatment of CRS has not been evaluated. We describe the epidemiology of children with CRS in a pediatric otolaryngology clinic and evaluate demographic differences when compared to a group of children referred for a general pediatric otolaryngology evaluation.
Study Design:
Historical cohort study.
Setting:
Tertiary academic care center.
Subjects And Methods:
All new/consult patients (March 1, 2008-July 1, 2011) in a tertiary pediatric otolaryngology clinic with primary diagnosis of CRS were compared to a control group that consisted of all new/consult patients seen in the same clinic over 3 months. Records were evaluated for variables including age, sex, race, and insurance. Characteristics were compared between groups using Mann-Whitney and Fisher's exact tests.
Results:
One hundred and seventy-four children with CRS were compared to 430 controls. When compared to the general pediatric otolaryngology population, children with CRS were older (8.2 ± 4.4 years vs 5.9 ± 4.8 years; P < .0001) and more commonly male (63% vs 52%; P = .018). When compared to controls, children with CRS were more likely to be white (CRS 77% white, 10% black, 13% other vs control 47% white, 33% black, 20% other; P < .0001, risk ratio [RR] = 2.7; 95% confidence interval [CI], 2.0-3.7). Likewise, children with CRS were less commonly insured with medical assistance (CRS 14% vs control 44%; P < .0001; RR = 0.3; 95% CI, 0.21-0.45).
Conclusions:
When compared to the general population of children seen in this academic urban pediatric otolaryngology setting, children with CRS were more likely to be white and privately insured. This study is the first to evaluate race and SES in relationship to pediatric CRS. Future research should employ nationally representative data to assess the true demographic variation in children with CRS.
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