US children with special health care needs and ethnic discrimination: results from multivariate modeling

To determine the prevalence of parent-reported ethnic/racial discrimination, and to determine if children with special health care needs are more likely to experience ethnic discrimination than other children who have similar family income, age, sex, race, parental education and Hispanic ethnicity.

Using the National Survey of Children's Health 2011-2012 (n = 95,677), ethnic discrimination was measured by two questions that asked "was child ever treated or judged unfairly because of his/her race or ethnic group?" and if so, how often it occurred in the last 12 months prior to the survey.

An estimated 3 million US children aged 0-17 years have experienced parent-reported ethnic discrimination (1.4% White, 9.1% Black, 9.9% other race, 4.7% Hispanic). The likelihood to experience ethnic discrimination is much higher for Black and other race children, compared to White children. Children with special health care needs were two times more likely to experience ethnic discrimination frequently in the 12 months prior to the survey than comparable children in terms of age, sex, race, family income, parental education, and social capital. Higher family income did not prevent the exposure to ethnic discrimination but was associated with fewer instances.

Theoretical frameworks, such as social determinants of health, must account for the bidirectional nature of the relationship between health and ethnic discrimination. Pediatric care must assess if ethnic discrimination has occurred and whether trauma-informed approaches are needed.