Ethnocultural Variations in the Prevalence and Impact of Childhood Chronic Conditions

Abstract

Chronic physical and mental illnesses are an important contributor to childhood morbidity. National survey data indicate that childhood chronic illnesses result in more than 35 million bed days and 40 million school absence days annually.1 There is also evidence to suggest that the burden of chronic illness is growing for children.2-4 Specifically, advances in diagnosis and treatment have dramatically changed mortality rates for children with chronic conditions, with the result that many children with life-threatening chronic conditions now survive into adulthood.5,6 In addition, a new class of childhood conditions, often referred to as the "new morbidities," has emerged in recent years.4,7 Despite concern about the welfare of this population, relatively little is known about the prevalence of childhood chronic conditions or their impact, especially for minority youth. Past studies have often categorized minority populations into the general and nonspecific category of "nonwhite." Alternatively some studies have reported results only for white and black children; hence published information is particularly sparse on chronic illness among Hispanic, Asian, and Native American children. Previous studies that have examined racial and ethnic variations in the prevalence of childhood chronic conditions can be divided into those that are based on household interviews, those based on medical records, and those based on birth-defects-monitoring systems. The results for some of the larger studies are summarized in Table 1. Excluded from this table are disease-specific studies. Only a few household interview studies have reported results concerning racial and ethnic differences in prevalence of chronic conditions. One of the earliest household interview studies to explore racial differences derived data from a survey of parents in Alamance County, North Carolina.8