NEW YORK—In many measures of health, Latino children fare far worse than any other group of American children. So says a panel of public and environmental health experts in a paper released July 3 in the Journal of the American Medical Association. The panel, the Latino Consortium of the Center for Child Health Research, was created by the American Academy of Pediatrics, the nation’s largest and most prestigious organization of pediatricians. “This report does very significant service by highlighting the great disparities in health that exist between Latino children and other children in this country and then in making ‘evidence-based’ recommendations in addressing those disparities,” said Dr. Philip Landrigan. Landrigan, a leading researcher in children’s health and head of the Center for Children’s Health and the Environment at the Mount Sinai School of Medicine, said the report is certain to make a difference for the better. “Any carefully considered health programs that benefit a quarter of American children [Latino children] are going to benefit all American children,” he said. The consortium identified several factors that contribute to poor health outcomes for Latino children. It pointed to cases in which non-English speakers are arbitrarily excluded from scientific study enrollment, leading to distortions in study outcomes, and to false claims that studies are ethnically or racially diverse when only African-Americans and whites are represented. And the group highlighted cases in which culture and language barriers prevent adequate access and care. “If you take the case of AIDS/ HIV prevention, there are very few interventions that have been tested to see if they are effective with this population,” said Antonia M. Villarruel, associate professor at the University of Michigan School of Nursing. “It’s a group that’s at risk, but nobody is targeting this population.” Villarruel said three things need to happen to improve health in Latino children&#151increased numbers of health care professionals of Latino background, greater awareness among the health care community, and better training to health care professionals about what tools are most effective and what scientific knowledge is or isn’t applicable with Latinos. Among the issues addressed by the consortium: failure by researchers to include Latino children in scientific studies; disproportionately high disease prevalence in Latino children; lack of access to quality health care; lack of cultural sensitivity within the scientific and health care fields; under-representation of Latinos in the health care work force. Numbers show that one out of every six children in the United States is Latino. In the year 2000, the U.S. census showed that most of these children have national origins in Puerto Rico, Mexico, the Dominican Republic and Cuba. Despite this growth, many of the needs of Latino children have not been met by the health care system. Barriers to quality health care contribute to poor health outcomes in Latino children. For instance, Latino children have disproportionately high risk of mental illness, developmental disabilities and dental health problems. In 1999, 19 percent of Latina adolescent girls were likely to have attempted suicide, compared to 9 percent of African Americans and 8 percent of whites. Puerto Rican children have a higher prevalence of asthma (11 percent) than any other ethnic group in the country. And, among children 5-14 years old, the proportion of teeth with carious surfaces is 65 percent for migrant children versus 17 percent for U.S. children. Among the other areas covered by the consortium: high prevalence of obesity and diabetes among Latino children, poor environmental health, and high rates of school dropout. Dr. Glenn Flores, a pediatrician at Boston University School of Medicine and chair of the 13-person consortium, said Latino children would suffer negative outcomes should health care policies remain as they are. “[Latino children] are going to continue to receive an inferior quality of care,” Flores said. “They’ll continue to face substantial barriers to health care and they’ll have difficulty accessing the system&#151from obtaining health insurance to getting a regular doctor.” Flores said overcoming barriers for Latino children benefits all children. “Some of the issues we’ve identified have universal application,” Flores said. “For example, if you can figure out how to improve insurance coverage for Latino children many of the successful interventions will be helpful in insuring all uninsured U.S. children.” The consortium&#151composed of 13 pediatricians, educators, public health experts, environmental health researchers, and a variety of health professionals&#151has created a list of recommendations, which they hope will influence policy makers to bring about crucial changes in the health research and care of Latino children, that will eventually benefit all American children. The consortium’s recommendations: 1. Greater inclusion of Latino children in medical research 2. Analysis of study data by pertinent Latino subgroups 3. Conducting more research on Latino child health issues that have the potential to elucidate social and economic determinants of health and use of health services for all children 4. Enhancing early educational opportunities for Latino children 5. More extensive cultural competency training of health care professionals 6. Increasing the number of Latinos in health care professions 7. Elimination of disparities in access to care, mental health, immunization coverage, oral health, quality of care, and environmental health * * * * * * * * · The Latino Consortium of the American Academy of Pediatrics’ Center for Child Health Research: Glenn Flores, MD, Department of Pediatrics, Boston University Schools of Medicine and Public Health/Boston Medical Center, Boston, MA; · Elena Fuentes-Afflick, MD, MPH, Department of Pediatrics, University of California, San Francisco, School of Medicine, San Francisco, CA; · Oxiris Barbot, MD, National Hispanic Medical Association and Soros Advocacy Fellow, Washington, D.C.; · Olivia Carter-Pokras, PhD, Office of Minority Health, Department of Health and Human Services, Rockville, MD; · Luz Claudio, PhD, Department of Community Medicine, Mount Sinai School of Medicine, New York, NY; · Marielena Lara, MD, MPH, Department of Pediatrics, UCLA School of Medicine, Los Angeles, CA; · Jennie A. McLaurin, MD, MPH, Migrant Clinician’s Network, Austin TX; · Lee Pachter, DO, Departments of Pediatrics and Anthropology, University of Connecticut School of Medicine, Saint Francis Hospital and Medical Center, Hartford, CT; · Francisco Ramos Gomez, DDS, MS, MPH, Department of Health Services Research, University of California, San Francisco, School of Dentistry, San Francisco, CA; · Fernando Mendoza, MD, MPH, Department of Pediatrics, Stanford University School of Medicine; Stanford, CA; · R. Burciaga Valdez, PhD, School of Public Health, MCP Hahnemann University, Philadelphia, PA, and RAND Health Science Program, Santa Monica, CA; · Antonia M. Villarruel, PhD, Division of Health Promotion and Risk Reduction Programs, School of Nursing, University of Michigan, Ann Arbor, MI; · Ruth E. Zambrana, PhD, Department of Women’s Studies, University of Maryland, College Park, MD · Robert Greenberg, MD, Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM; · Michael Weitzman, MD, Center for Child Health Research and University of Rochester School of Medicine, Rochester, NY. RELATED LINKS: Journal of the American Medical Association >> Latino Consortium >> Center for Child Health Research >> Kristina Nwazota
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