Introduction: State-of-the-Art on Child Health Disparities
Thirteen years ago, the Institute of Medicine issued a report entitled “Crossing the Quality Chasm.” This report highlighted gaps in quality health care and recommended that health care be safe, effective, patient-centered, timely, efficient, and equitable.1 The aim of equity in quality care addressed characteristics including gender, ethnicity, geographic location, and socioeconomic status. Two years later, the Institute of Medicine released another landmark report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.”2 This report reviewed the literature and documented racial/ethnic disparities in health care, concluding with recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, data collection, research, and other arenas.
Although the report importantly documented racial/ethnic disparities in the 103 studies reviewed, only 5 studies addressed child health. Because of the unique issues related to health care quality for children and adolescents and because of the relative dearth of research on child health disparities, the DC-Baltimore Research Center on Child Health Disparities, a collaboration between Howard University, Children’s National Medical Center, and Johns Hopkins University, convened a conference in 2008 to develop a research action agenda. The conference, entitled “Starting Early: A Life Course Perspective on Child Health Disparities,” included researchers, policy makers, and funders and published a research action agenda in a 2009 supplement to Pediatrics.3,4 The research action agenda emphasized the need for research on child health disparities, emphasizing intervention research and action.
Changes in the US health system and the Affordable Care Act bring renewed attention to persistent disparities in health care quality and the need to address population health. Financing models based on quality and safety measures and population health indicators provides an opportunity to address the biological and social determinants of health and the root causes of health disparities. This state-of-the-art series on child health disparities builds on the previous child health disparities action agenda in documenting the persistent racial/ethnic and socioeconomic status health disparities, reviewing conceptual frameworks to address disparities, and highlighting interventions to eliminate inequities. It is hoped that the data presented within this series will not only increase awareness of the scope of child health disparities nationally and globally but also locally. The new attention to quality measures and population health provides an excellent opportunity for all communities to improve health for all children.
- Accepted March 16, 2015.
- Address correspondence to Tina L. Cheng, MD, MPH, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University, 200 North Wolfe St, Suite 2055, Baltimore, MD 21287. E-mail:
Dr Cheng conceptualized and drafted the manuscript; Drs Moon, Horn, and Jenkins reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: Supported by the DC-Baltimore Research Center on Child Health Disparities grant P20 MD000198 from the National Institute on Minority Health and Health Disparities; Dr Cheng was supported by Centro SOL (Johns Hopkins Center for Salud/Health and Opportunity for Latinos). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Funded by the National Institutes of Health (NIH).
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
- Institute of Medicine
- Institute of Medicine
- Cheng TL,
- Dreyer BP,
- Jenkins RR
- Horn I and the DC Baltimore Research Center on Child Health Disparities Writing Group
- Copyright © 2015 by the American Academy of Pediatrics