Racial and Ethnic Disparities in Healthcare Utilization Among Youth in the Child Welfare System

Youth in the child welfare system have high healthcare needs, yet little is known about service utilization patterns across racial and ethnic groups. This study addresses these gaps by analyzing longitudinal trends and racial/ethnic disparities in healthcare utilization.

This retrospective cross-sectional study measured health and mental health service utilization among youth in the Ohio child welfare system, aged 5-17 years, with a first case opened between 2010-2019.

The sample included 98,015 youth: 73.7% were aged 5-12 years, 64.8% were non-Hispanic White, 29.8% non-Hispanic Black, and 5.4% Hispanic. Physical health outpatient visits were the most common visit type for all groups, however, Hispanic and non-Hispanic Black youth had lower odds of outpatient visits compared to White youth (adjusted odds ratio [AOR]=0.93, 95% confidence intervals [CI]=.89-0.97; AOR=0.73, 95% CI=.71-0.74, respectively). Trends in utilization changed over time, with rates of outpatient physical and mental health services increasing at higher rates. Non-Hispanic Black and Hispanic youth had higher odds of increased service use compared to non-Hispanic White youth.

This study highlights persistent racial/ethnic disparities in healthcare utilization among youth in the child welfare system. While outpatient visits increased over time, Hispanic and non-Hispanic Black youth consistently had lower odds these visits as compared to White youth. Findings suggest that despite progress, inequities in access to preventive and lower-intensity care remain.