Abstract
Not only do racial and ethnic minority children and adolescents with chronic illness experience disparities in health status and health outcomes, they also experience significant healthcare disparities, including differences in healthcare coverage, access to care, and quality of care. It is well known that the interaction between psychosocial functioning, health behaviors and ethnic and racial disparities, ultimately leads to worse health and psychosocial outcomes in pediatric and AYA chronic illness patient populations, including increased rates of morbidity and mortality. Investigating the impact of racial and ethnic factors on health outcomes, and strategies for reducing these disparities, is of the utmost importance, specifically in life-threatening conditions like cancer and sickle cell disease. This commentary underscores the relative importance of identifying factors that could reduce disparities between minority and non-minority populations. This present paper will focus on the dynamic relationships between health disparities, psychosocial factors and health outcomes within pediatric cancer, sickle cell disease and bone marrow transplant populations, and will offer recommendations for healthcare professionals working with these vulnerable patient populations. The primary goal of this commentary is to provide recommendations for enhancing cultural competency and humility for those working with highly vulnerable patient populations.
Highlights
According to the U.S National Center for Health Statistics, a chronic disease or illness is defined as a disease that lasts at least 3 months, with an expected duration of at least one year [1,2]
Given the multifaceted complexities of managing health-related and culturally-related factors that may influence health disparities among pediatric patients with a chronic illness, this paper provides careful considerations of the importance of cultural competence, and cultural humility in working with ethnic/racial minority pediatric patients and families
In a cohort of African American adolescents with sickle cell disease, Schwartz et al [61] identified ten components to consider when developing and providing effective interventions with this patient population, which included a focus on family-based interventions, emphasis on empowerment, recognition of stress related to ethnic minority status, identification of stress related to socioeconomic status, inclusion of culturally sensitive content, awareness of stigma attached to mental health problems, provision of community or home-based interventions, flexibility in scheduling, and ongoing training in cultural sensitivity with the clinical and research teams due to possible mistrust of the healthcare system, medical providers and research participation [61]
Summary
According to the U.S National Center for Health Statistics, a chronic disease or illness is defined as a disease that lasts at least 3 months, with an expected duration of at least one year [1,2]. There are several other factors that may explain some of the observed differences between minority and non-minority patient populations, leading to disparities in health outcomes, which include [4,6,13,14,15,16,17,18,19,20,21,22,23,24,25,26]: psychosocial functioning (individual, family); differences in treatment adherence including adherence to prescribed medications and frequency of medical follow-up; socioeconomic status; decreased access to much needed resources, such as transportation and prescription benefits; cultural differences; and decreased access to healthcare, especially for those who live in poverty-stricken environments or rural areas. Parents who are high in negative affect may be harder on children and adolescents with chronic illness who do not take responsibility for their own illness, when children and adolescents do not adhere to parental commands, such as reminders to take medications, leading to increased nonadherence behaviors [29]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call