Doing More About Health Care Disparities: Moving Past Description to Action.

Abstract

In this issue of Pediatrics , Goyal et al1 report race- and ethnicity-based differences in the receipt of antibiotics for acute respiratory viral illnesses over a 1-year period from sites participating in the Pediatric Emergency Care Applied Research Network. In their report, Goyal et al1 demonstrate that, regardless of race, non-Hispanic white children were given or prescribed antibiotics at a higher rate than non-Hispanic black patients or Hispanic children. Unfortunately, the findings in this study do not come as a surprise. Not only have researchers in other studies found differences in prescribing antibiotics in various pediatric practice settings but differences in all aspects of care, such as use of diagnostic testing, pain management, and even hospitalization rates.2–5 One of the challenges in assessing racial and ethnic disparities is in understanding the degree to which they are attributable to confounding factors such as socioeconomic status and access to care. In their study, Goyal et al1 control for insurance status but no other measures of socioeconomic status. Nonetheless the overall weight of scientific evidence supports that significant disparities exist on the basis of race and ethnicity. There was a time when results like this would have shocked us. That time is gone. We must recognize that we are biased in our treatment of patients. This does not mean we accept this fact. We should strive to provide care in our clinics and emergency departments that is of high … Address correspondence to Marvin B. Harper, MD, Division of Emergency Medicine, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail: marvin.harper{at}childrens.harvard.edu