• Otitis media;
  • disparities;
  • access to care;
  • epidemiology;
  • Level of Evidence: 2c



To evaluate current racial/ethnic and socioeconomic disparities in the prevalence of frequent ear infections (FEI) among children in the United States.

Study Design:

Cross-sectional study.


The National Health Interview Survey (years 1997 to 2006) was utilized to evaluate children who were reported by their parent/guardian to have “3 or more ear infections during the past 12 months.” Demographic variables evaluated included age, sex, race/ethnicity, income level, and insurance status. Multivariate analyses determined the influence of demographic variables on the prevalence of FEI in children.


Among an annualized population of 72.6 million children (average age, 8.55 ± 0.19 years), 4.65 ± 0.07 million children (6.6 ± 0.1%) reported FEI. FEI was more commonly reported in white (7.0 ± 0.1%) and Hispanic (6.2 ± 0.2%) than in black (5.0 ± 0.2%) and other race/ethnic groups (4.5 ± 0.3%, P < .001). A larger portion of children in households below the poverty level reported FEI (8.0 ± 0.3%, P < .001). Of children with no health insurance 5.4 ± 0.3% had FEI. On multivariate analysis, black, Hispanic and other race/ethnic group had decreased odds ratio for FEI relative to white children (odds ratios: 0.63, 0.76, and 0.60, respectively, all P < .001). Income below poverty level also predicted FEI (odds ratio, 1.322, P < .001), whereas lack of insurance coverage did not (P = .181).


Despite increasing awareness, there are still notable racial/ethnic and socioeconomic disparities among children with FEI. Further efforts to eliminate these disparities and improve the care of children with FEI are needed. Laryngoscope, 2010