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Racial/Ethnic and socioeconomic disparities in the prevalence and treatment of otitis media in children in the United States

Authors

  • David F. Smith MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
    2. Department of Otolaryngology–Head and Neck Surgery, Division of Pediatric Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
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  • Emily F. Boss MD

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
    2. Department of Otolaryngology–Head and Neck Surgery, Division of Pediatric Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
    • Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, 601 N. Caroline St., 6th Floor, Baltimore, MD 21287
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  • The authors have no financial or corporate interests to disclose associated with this work.

  • The authors declare that there are no conflicts of interest.

Abstract

Objectives:

Although racial/ethnic and socioeconomic disparities in child health are prevalent, little is known about them within common pediatric otolaryngic problems. Otitis media (OM) is a frequent diagnosis in children, and tympanostomy tube placement is the most common surgical treatment for OM. We sought to identify current knowledge regarding racial/ethnic and socioeconomic disparities in children with OM or tympanostomy tube placement.

Methods:

Qualitative systematic review of MEDLINE database for U.S.-based articles reporting on racial/ethnic or socioeconomic disparities in diagnosis or surgical treatment of OM over the last 30 years.

Results:

Of 428 abstracts identified, 15 met inclusion criteria. Articles addressed OM prevalence (12 of 15), risk factors (9 of 15), and tympanostomy tube insertion (4 of 15). Minority racial/ethnic groups studied were Black (11 of 15), Hispanic (6 of 15), American Indian/Alaska Native (2 of 15), and Asian (1 of 15). Predominant findings showed: 1) the most common identified risk factor for OM is socioeconomic status; 2) considerable variability exists concerning racial/ethnic disparities in disease prevalence; and 3) White children are more likely to undergo tympanostomy tube insertion compared to Black or Hispanic children.

Conclusions:

Racial/ethnic and socioeconomic disparities exist for the prevalence and treatment of children with OM. Socioeconomic deprivation increases the risk of OM in children. Despite the frequency of tympanostomy tube insertion in children in the United States, few studies have addressed inequalities in access or utilization of surgical therapy. Given the changing healthcare climate and the social and economic impact of OM in children, further investigation of racial/ethnic and socioeconomic disparities targeting access to surgical treatment of OM should take precedence in health services research. Laryngoscope, 2010

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