Racial, Ethnic, and Socioeconomic Disparities in the Prevalence of Cerebral Palsy

Wu, Yvonne W.; Xing, Guibo; Fuentes-Afflick, Elena; Danielson, Beate; Smith, Lloyd H.; Gilbert, William M.

doi:10.1542/peds.2010-1656

Cited by 82 publications

(101 citation statements)

References 33 publications

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“…A cross-sectional study of California children with CP born between 1991 and 2001 found that this disparity was attributable to the higher frequency of VLBW and MLBW among NHB children. 14 Recently, the Autism and Developmental Disabilities Monitoring (ADDM) Network reported a similar disparity, with higher CP prevalence among NHB compared with NHW children, which remained after adjustment for maternal education. 15 It is unclear whether these racial/ ethnic differences in CP prevalence in the United States have persisted over time.…”

mentioning

confidence: 97%

Birth Prevalence of Cerebral Palsy: A Population-Based Study

et al. 2016

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OBJECTIVE Population-based data in the United States on trends in cerebral palsy (CP) birth prevalence are limited. The objective of this study was to examine trends in the birth prevalence of congenital spastic CP by birth weight, gestational age, and race/ethnicity in a heterogeneous US metropolitan area. METHODS Children with CP were identified by a population-based surveillance system for developmental disabilities (DDs). Children with CP were included if they were born in metropolitan Atlanta, Georgia, from 1985 to 2002, resided there at age 8 years, and did not have a postneonatal etiology (n = 766). Birth weight, gestational age, and race/ethnicity subanalyses were restricted to children with spastic CP (n = 640). Trends were examined by CP subtype, gender, race/ethnicity, co-occurring DDs, birth weight, and gestational age. RESULTS Birth prevalence of spastic CP per 1000 1-year survivors was stable from 1985 to 2002 (1.9 in 1985 to 1.8 in 2002; 0.3% annual average prevalence; 95% confidence interval [CI] −1.1 to 1.8). Whereas no significant trends were observed by gender, subtype, birth weight, or gestational age overall, CP prevalence with co-occurring moderate to severe intellectual disability significantly decreased (−2.6% [95% CI −4.3 to −0.8]). Racial disparities persisted over time between non-Hispanic black and non-Hispanic white children (prevalence ratio 1.8 [95% CI 1.5 to 2.1]). Different patterns emerged for non-Hispanic white and non-Hispanic black children by birth weight and gestational age. CONCLUSIONS Given improvements in neonatal survival, evidence of stability of CP prevalence is encouraging. Yet lack of overall decreases supports continued monitoring of trends and increased research and prevention efforts. Racial/ethnic disparities, in particular, warrant further study.

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confidence: 97%

Birth Prevalence of Cerebral Palsy: A Population-Based Study

et al. 2016

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“…1–3 Numerous other sociodemographic, economic, biologic or psychosocial variables are typically included in these regressions. Some of these variables may be thought of as potentially on the pathway between race/ethnicity and the health outcome.…”

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confidence: 99%

On the Causal Interpretation of Race in Regressions Adjusting for Confounding and Mediating Variables

2014

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We consider several possible interpretations of the “effect of race” when regressions are run with race as an exposure variable, controlling also for various confounding and mediating variables. When adjustment is made for socioeconomic status early in a person’s life, we discuss under what contexts the regression coefficients for race can be interpreted as corresponding to the extent to which a racial inequality would remain if various socioeconomic distributions early in life across racial groups could be equalized. When adjustment is also made for adult socioeconomic status, we note how the overall racial inequality can be decomposed into the portion that would be eliminated by equalizing adult socioeconomic status across racial groups and the portion of the inequality that would remain even if adult socioeconomic status across racial groups were equalized. We also discuss a stronger interpretation of the “effect of race” (stronger in terms of assumptions) involving the joint effects of race-associated physical phenotype (e.g. skin color), parental physical phenotype, genetic background and cultural context when such variables are thought to be hypothetically manipulable and if adequate control for confounding were possible. We discuss some of the challenges with such an interpretation. Further discussion is given as to how the use of selected populations in examining racial disparities can additionally complicate the interpretation of the effects.

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“…Risk factors and casual pathways for CP was the most prevalent theme for this aim, and included investigation of maternal risk factors [115–120], genetics [121–124], term birth [125–128] and labor and delivery [37,129,130]. Other topics of research included preterm risk factors [131,132], reproductive technology [133,134], multiples [135,136], infant infection, [137] MRI findings and risk factors [138] ethnic/socioeconomic disparities [139] and predicting outcomes [140]. The two other Prevention studies related to predicting outcomes were classified concurrently with the Planning aim (Table S5) [141,142].…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Cerebral Palsy Registries/Surveillance Groups: Relationships between Registry Characteristics and Knowledge Dissemination

Hurley

Sukal-Moulton

Gaebler‐Spira

et al. 2015

Int J Phys Med Rehabil

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The aims of this study were to provide a comprehensive summary of the body of research disseminated by Cerebral Palsy (CP) registries and surveillance programs from January 2009 through May 2014 in order to describe the influence their results have on our overall understanding of CP. Secondly, registries/surveillance programs and the work they produced were evaluated and grouped using standardized definitions and classification systems.MethodA systematic review search in PubMed, CINAH and Embase for original articles published from 1 January 2009 to 20 May 2014 originating from or supported by population based CP registries and surveillance programs or population based national registries including CP were included. Articles were grouped by 2009 World CP Registry Congress aim, registry/surveillance program classification, geographical region, and the International Classification of Function, Disability and Health (ICF) domain. Registry variables were assessed using the ICF-CY classification.ResultsLiterature searches returned 177 articles meeting inclusion criteria. The majority (69%) of registry/surveillance program productivity was related to contributions as a Resource for CP Research. Prevention (23%) and Surveillance (22%) articles were other areas of achievement, but fewer articles were published in the areas of Planning (17%) and Raising the Profile of CP (2%). There was a range of registry/surveillance program classifications contributing to this productivity, and representation from multiple areas of the globe, although most of the articles originated in Europe, Australia, and Canada. The domains of the ICF that were primarily covered included body structures and function at the early stages of life. Encouragingly, a variety of CP registry/surveillance program initiatives included additional ICF domains of participation and environmental and personal factors.InterpretationCP registries and surveillance programs, including novel non-traditional ones, have significantly contributed to the understanding of how CP affects individuals, families and society. Moving forward, the global CP registry/surveillance program community should continue to strive for uniformity in CP definitions, variables collected and consistency with international initiatives like the ICF so that databases can be consolidated for research use. Adaptation to new technologies can improve access, reduce cost and facilitate information transfer between registrants, researchers and registries/surveillance programs. Finally, increased efforts in documenting variables of individuals with CP into adulthood should be made in order to expand our understanding of CP across the lifespan.

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Racial, Ethnic, and Socioeconomic Disparities in the Prevalence of Cerebral Palsy

Cited by 82 publications

References 33 publications

Birth Prevalence of Cerebral Palsy: A Population-Based Study

Birth Prevalence of Cerebral Palsy: A Population-Based Study

On the Causal Interpretation of Race in Regressions Adjusting for Confounding and Mediating Variables

Systematic Review of Cerebral Palsy Registries/Surveillance Groups: Relationships between Registry Characteristics and Knowledge Dissemination

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