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Racial and Ethnic Disparities in Healthcare Utilization Among Youth in the Child Welfare System
Farah W Brink1,2, Xueting Xia3, Danielle L Steelesmith3,4
1Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, Ohio.
Children and Youth Services Review
|July 8, 2026
Summary
Racial and ethnic disparities persist in healthcare access for children in the child welfare system. Despite increased service use over time, Black and Hispanic youth utilized fewer outpatient visits compared to White youth.
Area of Science:
- Child Welfare
- Health Services Research
- Health Equity
Background:
- Youth in child welfare systems exhibit significant healthcare needs.
- Understanding racial and ethnic disparities in service utilization is crucial.
Purpose of the Study:
- To analyze longitudinal trends in healthcare utilization among youth in the child welfare system.
- To identify racial and ethnic disparities in healthcare service use.
Main Methods:
- Retrospective cross-sectional study of 98,015 youth (aged 5-17) in Ohio's child welfare system (2010-2019).
- Examined physical and mental health outpatient service utilization across racial and ethnic groups.
Main Results:
- Physical health outpatient visits were most common across all groups.
- Hispanic and non-Hispanic Black youth had lower odds of outpatient visits compared to White youth.
- Utilization of outpatient services increased over time, with higher rates of increase for Black and Hispanic youth.
Conclusions:
- Persistent racial and ethnic disparities in healthcare utilization exist for youth in child welfare.
- Inequities in access to preventive and lower-intensity care remain despite overall increases in service use.
- Targeted interventions are needed to address disparities in healthcare access for vulnerable youth populations.
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