Expired CME Article

Black/White Differential Use of Health Services by Young Children in a Rural Mississippi Community

Authors: Philip Kum-Nji, MD, MPH, Carole L. Mangrem, MD, Peggy J. Wells, MD, Lisa M. Klesges, PHD, Henry G. Herrod, MD

Abstract

Background and Objectives:Use of health services in rural communities has not been well studied. We explored how black and white children used health services in a rural Mississippi community. Methods:Data were prospectively collected for 396 children attending a private practice to determine if race was associated with the use of health services in this community. Results:White children made more sick contacts than black children (P < 0.001). Black children (36%) were more likely to be treated in the emergency room than white children (24%; P = 0.013). There was no black-white difference in the hospitalization rates, although white children were more likely to undergo ear-nose-throat (ENT) surgery for pressure equalizing tube (PET) placement, and/or tonsillectomy and adenoidectomy (T&A; P < 0.001). Even after controlling for various confounders, the frequency of all physician sick contacts was twice as high for white children than for black children (RR = 2.17; 95% C.I. = 1.32-3.58). Conclusion:Overall, black children used disproportionately fewer health services than their white counterparts, but used significantly higher emergency room services. Private insurance coverage was the single most significant variable that accounted for the black-white differential use of the emergency room.

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