Identifying and addressing disparities in the evaluation and treatment of children with growth hormone deficiency

Abstract

Health disparities are a significant cause of concern globally and in the United States. Disparities have been additionally highlighted throughout the ongoing COVID-19 pandemic during which populations of color have been the most affected by the disease. Social determinants of health, race, ethnicity, and gender have all contributed to disparate outcomes and disparities spanning all age groups. Multiple socio-ecological factors contribute to disparities and different strategies have been proposed. The purpose of this paper is to provide an overview of disparities in pediatric treatment and outcomes, with a focus on children with endocrine disorders.

Evolving growth hormone deficiency: proof of concept

“…There were too few females in our cohort, and hence the analyses were only limited to male patients. This is consistent with gender disparities, reported previously in idiopathic GHD ( 28 ).…”

“…This case series highlighted the importance of follow-up of children with unidentified causes of short stature and retesting with GST, especially since they may have been termed as ‘Idiopathic short stature’ otherwise. Our team recently reported two male patients (also currently included in this study) with poor growth and pubertal progression who initially had normal GST but were later diagnosed with EGHD and benefitted from GH therapy ( 28 ). GSTs are useful tools in diagnosing GHD, especially in those without obvious causes of GHD such as intracranial tumors or irradiation ( 9 ).…”

Assessment of childhood short stature: a GP guide

“…It is helpful to recognise that currently girls and ethnic minority groups with short stature are less likely to be referred, assessed, and treated despite their greater need. 4 , 5 It is crucial that clinicians recognise their implicit biases and understand the social disparities in the assessment of childhood short stature to improve timely diagnosis, referral, and early access to treatment. 6 This article outlines how to undertake a targeted assessment in a child presenting with short stature.…”

Testes farmacológicos de estímulo de GH em crianças e adolescentes: análise dos exames realizados no HCFMRP-USP nos últimos 15 anos

“…Sobre os dados que caracterizam a população estudada, observou-se que a maioria dos pacientes era do sexo masculino (60%). Este dado se assemelha aos dados observados em outros estudos, [21][22][23][24] e pode sugerir uma maior preocupação relativamente à estatura no sexo masculino por parte tanto de cuidadores como de médicos. 24 A proporção de pacientes com BE leve/moderada e com BE grave foi semelhante, enquanto 27% dos pacientes submetidos a teste de GH apresentavam estatura normal.…”

“…23 Por outro lado, em diversos estudos, este diagnóstico parece ser feito com mais frequência no sexo masculino do que no feminino. 24 Não existem dados sobre a prevalência desta condição na população brasileira.…”