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Disparities in Pediatric Admissions for Growth Faltering.

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Black children with growth faltering (GF) experienced disparities in care, presenting with lower weight-for-age z scores and increased social work and Child Protective Services referrals compared to white children.

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Area of Science:

  • Pediatric Health
  • Health Disparities
  • Growth Disorders

Background:

  • Growth faltering (GF) affects children globally, with potential disparities in care based on race, ethnicity, and socioeconomic status.
  • Understanding these disparities is crucial for equitable healthcare delivery.

Purpose of the Study:

  • To investigate racial, ethnic, and socioeconomic differences in the admission criteria and inpatient treatment of children diagnosed with GF.
  • To identify specific patterns in laboratory tests, consultations, and interventions.

Main Methods:

  • Retrospective review of medical records for children aged 1-24 months diagnosed with GF from 2012-2022.
  • Analysis of demographic data, growth parameters (weight-for-age z scores - WFAZ), and inpatient treatments.
  • Generalized estimating equations with logit link were used for data analysis.

Main Results:

  • The study included 982 encounters (890 unique patients), predominantly white (69%) and Medicaid recipients (60%).
  • Black patients had higher area deprivation index scores and lower admission/discharge WFAZ compared to white patients.
  • Black patients showed increased social work consultations and Child Protective Services referrals, while white patients had higher lactation consultation rates.

Conclusions:

  • Significant differences in consultations based on race and socioeconomic status were observed for children admitted with GF.
  • Black patients presented with more severe GF (lower WFAZ), correlating with increased social work and CPS referrals.
  • Further research is needed to address the factors contributing to these disparities in pediatric GF care.