Racial/Ethnic Disparities in Risk of Early Childhood Mortality Among Children With Congenital Heart Defects

Nembhard, Wendy N.; Salemi, Jason L.; Ethen, Mary K.; Fixler, David E; Dimaggio, A; Canfield, Mark A.

doi:10.1542/peds.2010-2702

Cited by 85 publications

(77 citation statements)

References 47 publications

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“…Hazard models have been used to investigate racial/ ethnic disparities in conditions and disorders other than ADHD. 34- 36 We also used logistic regression modeling to estimate racial/ethnic disparities in prescription medication use. Table 3 shows these estimates, without and with adjustment for confounding factors.…”

Section: Analytic Methodsmentioning

confidence: 99%

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Morgan¹,

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Minority children are less likely than white children to be diagnosed and treated with attentiondeficit/hyperactivity disorder. However, diagnosis patterns over time in early and middle childhood and whether confounding factors explain these disparities are not currently well understood.WHAT THIS STUDY ADDS: Racial/ethnic disparities in attentiondeficit/hyperactivity disorder diagnosis occur by kindergarten and continue until eighth grade. Racial/ethnic disparities among diagnosed children in medication use occur in both fifth and eighth grades. These disparities are not attributable to confounding factors. abstract OBJECTIVE: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade. METHODS: Analyses of the nationally representative Early ChildhoodLongitudinal Study, Kindergarten Class of 1998-1999 (N = 17 100) using discrete-time hazard modeling.RESULTS: Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%-76%), 50% (95% CI: 34%-62%), and 46% (95% CI: 26%-61%) lower, respectively, than for whites. Factors increasing children' s risk of an ADHD diagnosis included being a boy, being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children' s risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder.CONCLUSIONS: Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed, and treated for ADHD. Pediatrics 2013;132:85-93

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Section: Analytic Methodsmentioning

confidence: 99%

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Morgan¹,

et al. 2013

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“…4,5 None of the postsurgical studies was population based, however, and hence could not account for mortality before referral or for patients not having had surgery. Nembhard and coworkers 6 reported in their population-based study of Texas CHD births, that Hispanic children with pulmonary valve atresia and intact ventricular septum (PA-IVS) had a 76% higher mortality risk and those with hypoplastic left heart syndrome (HLHS) a 51% higher risk than NH-white children over the first 5 years of life. A similar study of Texas patients with functional single ventricle (SV) found a higher mortality in Hispanic children and in patients who resided in counties bordering Mexico, areas where cardiac surgical centers are relatively distant and where more than 60% speak Spanish at home.…”

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confidence: 99%

Effect of Acculturation and Distance From Cardiac Center on Congenital Heart Disease Mortality

Fixler

Nembhard

et al. 2012

Pediatrics

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“…The results are consistent with observations during a quiescent period of 10 to 15 years after corrective surgery in TOF patients, followed by a steady increase of the event rates of atrial and ventricular arrhythmias. [8][9][10][11][17][18][19] Although NHI started to reimburse ICD treatment as secondary prevention for sudden death in 2003, fewer than half of the survivors of VT/VF patients received ICD therapy. This rate is similar to the rate reported by the Alliance for Adult Research in Congenital Cardiology, in which one-third of the patients with VT and VF received an ICD as secondary prevention.…”

Section: Discussionmentioning

confidence: 99%

Arrhythmic burdens in patients with tetralogy of Fallot: A national database study

Chen

et al. 2015

Heart Rhythm

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Racial/Ethnic Disparities in Risk of Early Childhood Mortality Among Children With Congenital Heart Defects

Abstract: We provide evidence that supports racial/ethnic disparities in early childhood mortality among infants with CHDs. Identifying infants with the greatest risk of early childhood mortality will facilitate development of interventions and policies to mitigate these risks.

Cited by 85 publications

References 47 publications

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade

Effect of Acculturation and Distance From Cardiac Center on Congenital Heart Disease Mortality

Arrhythmic burdens in patients with tetralogy of Fallot: A national database study

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