Racial/ethnic disparities in the diagnosis of otitis media in infancy

Vernacchio, Louis; Lesko, Samuel M.; Vezina, Richard M.; Corwin, Michael J.; Hunt, Carl E.; Hoffman, Howard J.; Mitchell, Allen A.

doi:10.1016/j.ijporl.2004.01.012

Cited by 54 publications

(67 citation statements)

References 32 publications

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“…For example, Black infants included in a study at Boston University were less likely to be diagnosed with OM than White children. 20 Similarly, a bivariate analysis from the Third National Health and Nutrition Examination Survey showed that the risk of having any ear infection was lower in non-Hispanic Black children when compared to White children. 19 Alternatively, Black infants in the Pittsburgh area had a higher cumulative proportion of days with middle ear effusion when compared to White infants.…”

Section: Discussionmentioning

confidence: 99%

“…23 One study stated that the prevalence of OM was less in Asian children than White children. 20 A greater prevalence of OM in American Indian/Alaskan Native children compared to the general U.S. population was described in two of the studies. 24,25 Last, five studies addressed the prevalence of OM in children with socioeconomic deprivation compared to children in higher socioeconomic strata.…”

Section: Prevalence Of Otitis Media In Racial/ethnic and Socioeconomimentioning

confidence: 91%

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

Boss

2010

The Laryngoscope

111

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Prevalence Of Otitis Media In Racial/ethnic and Socioeconomimentioning

confidence: 91%

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

Boss

2010

The Laryngoscope

111

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“…These differences could be due to ethnic variations in socio-economic factors (Vernacchio et al 2004) or in illness-seeking behavior (Park et al 2002), as well as genetics, but because many studies have been retrospective they have been unable to control for such confounders. Furthermore studies have been contradictory, and the conclusions of systematic (Smith & Boss 2010) relatively small total and demic population sizes, and each of these populations lived in relative geographic and social isolation.…”

Section: Ethnic Variations In Otitis Media Incidencementioning

confidence: 99%

Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations

Bhutta¹

2015

Human Biology

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Inflammation of the middle ear (otitis media) comprises a group of disorders that are highly prevalent in childhood, and indeed are amongst the most common disorders of childhood. Otitis media is also heritable, and has effects on fecundity. This means that otitis media is subject to evolution, yet the evolutionary selection forces that may determine susceptibility to otitis media have never been adequately explored.Here I undertake a critical analysis of evolutionary forces that may determine susceptibility to middle ear inflammation. These forces include those determining function of the middle ear, those affecting host immunity, and those affecting colonization by, and pathogenicity of bacteria. I review existing mathematical evolutionary models of host-pathogen interaction and co-evolution, and apply these to develop a better understanding of the complex evolutionary landscape of middle ear infection and inflammation in humans. This includes an understanding of factors Pre--print version. Visit http://digitalcommons.wayne.edu/humbiol/ after 1 October 2015 to acquire the final version.2 determining the transition between stable evolutionary strategies for host and bacterial pathogens. This understanding will be later applied to analysis of otitis media in indigenous populations.In the second part of this article, I apply the approach of population genetics to devise a new theory for the high prevalence of otitis media in certain indigenous populations: the Australian Aborigine, the Native American, the Inuit, and the Maori.I suggest that high prevalence in such groups may have occurred as a result of colonization of these previously isolated populations by European immigrants in the 15 th and 16 th Centuries. This exposed them to new strains of bacteria to which their immune system had not evolved immunity, perturbing a previously stable hostpathogen co-evolutionary state.

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“…Differential diagnostic misclassification is possible in this setting and could bias our results. For instance, Vernacchio et al, (2004) find that black and Asian infants are less likely to be diagnosed with otitis media than White children. Such under-reporting for non-White groups can bias our nonWhite estimates downwards.…”

Section: E11mentioning

confidence: 99%

Emergency Department Utilization in the Texas Medicaid Emergency Waiver

Quast

Mortensen

2011

MMRR

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Objective: To estimate the enrollment and emergency department (ED) utilization in TexKat, the TexasMedicaid emergency waiver implemented following Hurricane Katrina. Data Sources:Individual-level enrollment and utilization data from the 2005 Medicaid Analytic Extract. Study Design: Descriptive analysis is performed on variables that describe enrollment levels, the demographic characteristics of enrollees, and the most common diagnoses in ED visits. A Poisson regression model is also employed to quantify the factors related to an enrollee's probability of having an ED visit and the average number of ED visits.Principal Findings: There were 44,246 individuals enrolled in TexKat in 2005. Roughly 13% of these enrollees had at least one ED visit during the sample period, with one quarter of these individuals having more than one visit. Across all enrollees the most common diagnosis was "other upper respiratory infection," but there were significant differences in diagnosis patterns across racial/ethnic groups. The regression analysis suggests little difference in ED utilization across genders, but significant contrasts across racial/ethnic and age groups. Conclusions:As very little is known about Medicaid emergency waivers, our analysis may provide important information to policymakers who have to react quickly following a disaster. Our findings may help providers estimate potential increases in ED utilization and prepare for relatively common diagnoses. Furthermore, the analysis across racial/ethnic groups may help government officials identify important areas for outreach among vulnerable populations.

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Racial/ethnic disparities in the diagnosis of otitis media in infancy

Cited by 54 publications

References 32 publications

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

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

Evolution and Otitis Media: A Review, and a Model to Explain High Prevalence in Indigenous Populations

Emergency Department Utilization in the Texas Medicaid Emergency Waiver

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