Child Health Disparities in the 21st Century.

The topic of persistent child health disparities remains a priority for policymakers and a concern for pediatric clinicians. Health disparities are defined as differences in adverse health outcomes for specific health indicators that exist across sub-groups of the population, frequently between minority and majority populations. This review will highlight the gains that have been made since the 1990s as well as describe disparities that have persisted or have worsened into the 21st century.

Stridor is not always croup.

Respiratory distress and stridor are common presenting symptoms for children in the emergency department. Most of these children will have common illnesses such as bronchiolitis or croup. Clinicians, however, must maintain a broad differential diagnosis and a healthy skepticism in the approach to each child's case so as not to miss uncommon or atypical presentations.

Correlation of blood pressure readings from 6-hour intervals with the daytime period of 24-hour ambulatory blood pressure monitoring in pediatric patients.

Shorter-interval (6-hour) ambulatory blood pressure monitoring (ABPM) has been shown to correlate well with 24-hour ABPM in adults, but this has not been studied in children. The authors selected 131 patients aged 9 to 18 who underwent 24-ABPM from 2000-2008. Six-hour intervals beginning at different start times were compared with the daytime and 24-hour period, with subset analysis for normotensive and hypertensive patients.

Patient identified needs for chronic obstructive pulmonary disease versus billed services for care received.

The American Lung Association of Minnesota (ALAMN) was granted access to a 2004 administrative claims data from an upper mid-Western, independent practice association model health plan. Claims information, including demographics, prevalence, medication and oxygen therapy, and health care utilization, was extracted for 7,782 patients with COPD who were 40 years of age and older. In addition, ALAMN conducted a survey of 1,911 patients from Minnesota diagnosed with COPD.

Multi-method approach to evaluate inequities in prenatal care access in Haiti.

In this pilot study for evaluating equity in services at a hospital in rural Haiti, we investigated whether topography, walking time to dispensary, and presence of a mobile clinic were related to disparities in prenatal care utilization, using quantitative hospital record data on 100 women pregnant in 2002. We also assessed whether additional factors contributed to prenatal care disparities using qualitative key informant interviews with local health agents in Haiti. In logistic regression analyses, we found that walking time to the dispensary was associated with disparities in prenatal care utilization (p = .

Development of a hospital-based trauma registry in Haiti: an approach for improving injury surveillance in developing and resource-poor settings.

Background: Trauma-related morbidity and mortality are a growing burden in the developing world. However, usable injury data in resource-poor and developing settings is lacking. Trauma registries can improve injury surveillance to enhance trauma care, outcomes, and prevention.

Health equity issues at the local level: socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti.

Background: Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS) in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years.