Ethnic Disparities in Health Care Providers' Response to Parent Concerns

Diagnosis of autism at a young age is critical because it allows children to begin early intervention as young as possible, and thereby maximize the benefits. Research indicates interventions are most effective in younger children, and intervention yields fewer improvements in older children (Ben Itzchak & Zachor, 2011). Conversely, as early ASD diagnosis is critical in improving children’s functioning, some of the racial and ethnic disparities in severity and outcomes among children with ASD may be explained by the vast disparities in age at diagnosis among children of color (Gourdine, Baffour & Teasley, 2011).  This study aimed to understand whether there were ethnic disparities in when parents noticed developmental delays in their children, and whether there were ethnic disparities in health care providers’ responsiveness to parent-reported concerns.

The results of this study are derived from an analysis of the 2011 Survey of Pathways to Diagnosis and Services (Pathways Survey), which was a subsample of families who participated in the 2009-2010 National Survey of Children with Special Health Care Needs (n=70 Latino children and 411 non-Latino white children with autism). The independent variable was whether the child’s ethnicity was Latino. The dependent variables were child’s age at which the parent noticed developmental concerns, and whether the child’s health care provider responded proactively or negatively to parent-reported concerns. Multivariate logistic regressions models were estimated, controlling for a range of socio-demographic characteristics, including parent education, whether the family lived in an urban area, child’s insurance type, whether the child had a usual source of care, child’s age and severity of condition.

There were no significant differences in child’s age when Latino and white parents were first concerned about their child’s development or in the child’s age at autism diagnosis. Latino parents were significantly more likely to report receiving a negative response from their health care provider after bringing up concerns about their child’s development. These results persisted after controlling for all model covariates.

There were no differences in the time at which parents recognized developmental problems in their children who were later diagnosed with autism.  However, even though Latino and non-Latino white parents notice their children’s problems at the same time, health care providers responded differentially to Latino and non-Latino White parents. Once concerns are reported, Latino children were more likely to receive a negative response from their child’s health care providers. Health care providers and policymakers must take assertive action to eliminate ethnic disparities in the responsiveness of health care providers.

References

Ben Itzchak E, & Zachor DA. (2011). Who benefits from early intervention in autism spectrum disorders? Research in Autism Spectrum Disorders, 5(1), 345-350.

Gourdine, R.M., Baffour, T.D., and  Teasley, M. (2011). Autism and the African American community. Social Work in Public Health, 26 (4) , 454–470.