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Racial Disparities in the Emergency Department Evaluation of Adolescent Girls
Samuel Polhemus, Michelle L Pickett1, Xuerong Joy Liu2
1From the Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
Pediatric Emergency Care
|March 30, 2022
Summary
Non-White adolescents with abdominal pain received more thorough evaluations, including sexual history and testing for sexually transmitted infections (STIs) and pregnancy, compared to White adolescents. This racial disparity in emergency care suggests potential implicit bias influencing medical practice.
Area of Science:
- Emergency Medicine
- Pediatric Healthcare
- Health Disparities
Background:
- Standard care for adolescents with abdominal pain includes obtaining a sexual history.
- Testing for sexually transmitted infections (STIs) and pregnancy is guided by historical findings.
Purpose of the Study:
- To investigate racial disparities in emergency care for adolescent females with abdominal pain.
- To determine if race influences the documentation of sexual history, STI testing, and pregnancy testing.
Main Methods:
- Retrospective chart review of female patients aged 14-18 with abdominal pain.
- Analysis of patient and provider characteristics, sexual history, STI, and pregnancy testing documentation.
- Statistical analysis using chi-squared test and logistic regression.
Main Results:
- Non-White patients were more likely than White patients to have documented sexual history (59.9% vs 44.0%), STI testing (24.8% vs 7.8%), and pregnancy testing (76.6% vs 66.2%).
- The racial disparity in STI testing persisted among sexually active patients (P = 0.010).
- Provider characteristics did not influence these disparities.
Conclusions:
- Differential care was observed, with non-White adolescents receiving more comprehensive evaluations.
- This disparity, while resulting in better documented care for non-White adolescents, may stem from implicit bias.
- Further research is needed to understand the root causes and implications of these racial disparities in emergency care.
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