WHAT'S KNOWN ON THIS SUBJECT: Racial/ethnic differences in care for adult and pediatric patients in the emergency department have been documented. WHAT THIS STUDY ADDS:This study reveals racial/ethnic differences in analgesic administration and prolonged length of stay for pediatric emergency department visits for abdominal pain. Documenting such disparities is an important first step needed to improve the equity of care for this and other conditions. abstract OBJECTIVE: To determine if race/ethnicity-based differences exist in the management of pediatric abdominal pain in emergency departments (EDs). METHODS: Secondary analysis of data from the 2006-2009 NationalHospital Ambulatory Medical Care Survey regarding 2298 visits by patients #21 years old who presented to EDs with abdominal pain. Main outcomes were documentation of pain score and receipt of any analgesics, analgesics for severe pain (defined as $7 on a 10-point scale), and narcotic analgesics. Secondary outcomes included diagnostic tests obtained, length of stay (LOS), 72-hour return visits, and admission. RESULTS:Of patient visits, 70.1% were female, 52.6% were from nonHispanic white, 23.5% were from non-Hispanic black, 20.6% were from Hispanic, and 3.3% were from "other" racial/ethnic groups; patients' mean age was 14.5 years. Multivariate logistic regression models adjusting for confounders revealed that non-Hispanic black patients were less likely to receive any analgesic (odds ratio CONCLUSIONS: Race/ethnicity-based disparities exist in ED analgesic use and LOS for pediatric abdominal pain. Recognizing these disparities may help investigators eliminate inequalities in care.[

This review examines published literature to answer 2 questions: 1) Are there racial-ethnic differences in excessive or inadequate gestational weight gain (GWG) and postpartum weight retention (PPWR)? and 2) Is there evidence that approaches to promote healthy weight during and after pregnancy should vary by race-ethnicity? We identified a limited number of articles that explicitly looked at racial-ethnic differences in either GWG or PPWR after controlling for relevant covariates. These studies suggest that black and Hispanic women are more likely to gain inadequately based on the Institute of Medicine's pregnancy weight gain guidelines compared to white women. Black women are more likely to retain considerable amounts of weight postpartum compared to both Hispanic and white mothers. Studies were inconclusive as to whether Hispanic women retained more or less weight postpartum, so more research is needed. Interventions to increase GWG were few and those designed to reduce GWG and PPWR showed mixed results. Future studies should address the methodological and conceptual limitations of prior research as well as investigate biological mechanisms and behavioral risk factors to determine the reasons for the racial-ethnic differences in pregnancy-related weight outcomes. Interventions would benefit from a mixed-methods approach that specifically identifies race-relevant barriers to weight management during and after pregnancy. Attention to the greater social context in which pregnancy-related weight exists is also needed.

Focus groups stratified by race and socioeconomic status were used to examine obese women's experiences with weight-loss methods. Six themes emerged: failure of weight maintenance, use of psychological and spiritual approaches, role of family influences and societal expectations, role of African American subculture, method affordability, and racial differences in weight-loss methods. Tailored weight-management interventions for women, particularly African Americans and those of low socioeconomic status, should account for features of African American subculture and address affordability concerns, include maintenance strategies that incorporate psychological and spiritual principles, and target family attitudes and behaviors.