RESUMEN
OBJECTIVE: The objective of this study was to examine the potential compounding effect of race/ethnicity, and disability status on children's health and health care, stratified by selected geographies. METHODS: We used the 2011/2012 NSCH and the 2012 Boston Survey of Children's Health for our compounded disparity analysis. We used VanderWheel and Knol method to first predict combined risk ratios of race/ethnicity and disability and then compared them with the observed combined risk ratios. RESULTS: We demonstrated that racial/ethnic minority children with disabilities experience additional disparities in health care access outcomes that are greater than the sum of the effects from either characteristic alone. Further, we demonstrate that disparities persist across all selected geographies irrespective of whether children lived in states or metropolitan cities with the best health care systems in the United States. CONCLUSIONS: Despite reform efforts, our study demonstrates that racial/ethnic minority children with disabilities experience a double burden. Given the deleterious compounded disparities, public health and social service programs at all geographical levels should prioritize identifying participants that face this and tailor programs to meet their needs.
Asunto(s)
Salud Infantil/estadística & datos numéricos , Niños con Discapacidad/estadística & datos numéricos , Etnicidad/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Grupos Raciales/estadística & datos numéricos , Adolescente , Negro o Afroamericano/estadística & datos numéricos , Factores de Edad , Niño , Preescolar , Femenino , Mapeo Geográfico , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Lenguaje , Masculino , Índice de Severidad de la Enfermedad , Factores Sexuales , Factores Socioeconómicos , Estados Unidos/epidemiologíaRESUMEN
We combined survey, mobility, and infections data in greater Boston, MA to simulate the effects of racial disparities in the inclination to become vaccinated on continued infection rates and the attainment of herd immunity. The simulation projected marked inequities, with communities of color experiencing infection rates 3 times higher than predominantly White communities and reaching herd immunity 45 days later on average. Persuasion of individuals uncertain about vaccination was crucial to preventing the worst inequities but could only narrow them so far because 1/5th of Black and Latinx individuals said that they would never vaccinate. The results point to a need for well-crafted, compassionate messaging that reaches out to those most resistant to the vaccine.