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Trends in Health Equity Among Children in the United States, 1997–2018

OBJECTIVES: Health equity is crucial to population health. To achieve this aim, extensive monitoring efforts beyond traditional disparities research are required. This analysis assesses trends in health equity for children from 1997 to 2018. METHODS: Health equity in a given year is calculated using...

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Autores principales: Anderson, Nathaniel W., Zimmerman, Frederick J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517319/
https://www.ncbi.nlm.nih.gov/pubmed/34652594
http://dx.doi.org/10.1007/s10995-021-03253-w
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author Anderson, Nathaniel W.
Zimmerman, Frederick J.
author_facet Anderson, Nathaniel W.
Zimmerman, Frederick J.
author_sort Anderson, Nathaniel W.
collection PubMed
description OBJECTIVES: Health equity is crucial to population health. To achieve this aim, extensive monitoring efforts beyond traditional disparities research are required. This analysis assesses trends in health equity for children from 1997 to 2018. METHODS: Health equity in a given year is calculated using a previously developed measure as the mean weighted departure of individual health from the best achievable level of health. This criterion is defined as the median health of the most socially privileged identifiable group: white, non-Latinx boys in upper-income households. Using more than 20 years of data from the National Health Interview Survey, we apply this methodology to six measures of child health: parent-reported health status, school days missed due to illness or injury in the past year, a strength and difficulties questionnaire score, emotional difficulties, a toddler mental health indicator score, and toddler depression. We separately calculate racial/ethnic and income disparities. Monte Carlo simulation is used to assess whether trends are statistically significant. RESULTS: Health equity among children increased gradually over the past 2 decades, with five of the six measures demonstrating upward trends. Improvements in health equity are stronger among younger children (age 0–3 and 4–7). Unlike previous work examining adults, both types of disparities narrowed over the study period. CONCLUSIONS FOR PRACTICE: Progress on health equity requires accountability to an objective metric. This analysis suggests some improvement over the past two decades, although these gains are under threat from potential decreases in government spending on programs affecting children and the COVID-19 pandemic.
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spelling pubmed-85173192021-10-15 Trends in Health Equity Among Children in the United States, 1997–2018 Anderson, Nathaniel W. Zimmerman, Frederick J. Matern Child Health J Article OBJECTIVES: Health equity is crucial to population health. To achieve this aim, extensive monitoring efforts beyond traditional disparities research are required. This analysis assesses trends in health equity for children from 1997 to 2018. METHODS: Health equity in a given year is calculated using a previously developed measure as the mean weighted departure of individual health from the best achievable level of health. This criterion is defined as the median health of the most socially privileged identifiable group: white, non-Latinx boys in upper-income households. Using more than 20 years of data from the National Health Interview Survey, we apply this methodology to six measures of child health: parent-reported health status, school days missed due to illness or injury in the past year, a strength and difficulties questionnaire score, emotional difficulties, a toddler mental health indicator score, and toddler depression. We separately calculate racial/ethnic and income disparities. Monte Carlo simulation is used to assess whether trends are statistically significant. RESULTS: Health equity among children increased gradually over the past 2 decades, with five of the six measures demonstrating upward trends. Improvements in health equity are stronger among younger children (age 0–3 and 4–7). Unlike previous work examining adults, both types of disparities narrowed over the study period. CONCLUSIONS FOR PRACTICE: Progress on health equity requires accountability to an objective metric. This analysis suggests some improvement over the past two decades, although these gains are under threat from potential decreases in government spending on programs affecting children and the COVID-19 pandemic. Springer US 2021-10-15 2021 /pmc/articles/PMC8517319/ /pubmed/34652594 http://dx.doi.org/10.1007/s10995-021-03253-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Anderson, Nathaniel W.
Zimmerman, Frederick J.
Trends in Health Equity Among Children in the United States, 1997–2018
title Trends in Health Equity Among Children in the United States, 1997–2018
title_full Trends in Health Equity Among Children in the United States, 1997–2018
title_fullStr Trends in Health Equity Among Children in the United States, 1997–2018
title_full_unstemmed Trends in Health Equity Among Children in the United States, 1997–2018
title_short Trends in Health Equity Among Children in the United States, 1997–2018
title_sort trends in health equity among children in the united states, 1997–2018
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517319/
https://www.ncbi.nlm.nih.gov/pubmed/34652594
http://dx.doi.org/10.1007/s10995-021-03253-w
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