The impact of ethnicity, family income, and parental education on children's health and use of health services

Objectives. This study characterized ethnic disparities for children in dem ographics, health status, and use of services; explored whether ethnic subg roups (Puerto Rican, Cuban, and Mexican) have additional distinctive differ ences; and determined whether disparities are explained by differences in f amily income and parental education. Methods. Bivariate and multivariate analyses of data on 99 268 children fro m the 1989-91 National Health Interview Surveys were conducted. Results. Native American, Black and Hispanic children are poorest (35%-41% below poverty level vs 10% of Whites), least healthy (66%-74% in excellent or very good health vs 85% of Whites), and have the least well educated par ents. Compared with Whites, non-White children average fewer doctor visits and are more likely to have excessive intervals between visits. Hispanic su bgroup differences in demographics graphics, health, and use of services eq ual or surpass differences among major ethnic groups. In multivariate analy ses, almost all ethnic group disparities persisted after adjustment for fam ily income, parental education, and other relevant covariates. Conclusions. Major ethnic groups and subgroups of children differ strikingl y in demographics, health, and use of services; subgroup differences are ea sily overlooked; and most disparities persist even after adjustment for fam ily income and parental education.