Ambulatory Pediatrics
Volume 4, Issue 4 , Pages 276-282 , July 2004

Culture, Ethnicity, and Linguistic Issues in Pediatric Care: Urgent Priorities and Unanswered Questions

  • Glenn Flores, MD

      Affiliations

    • Corresponding Author InformationAddress correspondence to Glenn Flores, MD, Center for the Advancement of Urban Children, Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226

REFERENCES 

  1. US Bureau of the Census. . Current Population Survey, 2003 Annual Social and Economic Supplement Table HI08. Health Insurance Coverage Status and Type of coverage by Selected Characteristics for Children Under 18 . Washington, DC: US Bureau of the Census; 2002; Available at: http://ferret.bls.census.gov/macro/032003/health/h08_000.htm Accessed March 23, 2004
  2. New York: http://censtats.census.gov/data/NY/1603651000.pdf; Los Angeles: http://censtats.census.gov/data/CA/1600644000.pdf; Chicago: http://censtats.census.gov/data/IL/1601714000.pdf; Houston: http://censtats.census.gov/data/TX/1604835000.pdf; Philadelphia: http://censtats.census.gov/data/PA/1604260000.pdfAccessed March 23, 2004
  3. State of California, Department of Finance. . County Population Projections with Age, Sex, and Race/Ethnic Detail, July 1, 1990–2040 . Available at: http://www.dof.ca.gov/html/Demograp/projca.pdf Accessed March 30, 2004
  4. US Bureau of the Census. . Population Projections of the United States by Age, Sex, Race, and Hispanic Origin . Washington, DC: US Bureau of the Census; 1995 to 2050; Available at: http://www.census.gov/prod/1/pop/p25–1130/p251130.pdf Accessed January 8, 2004
  5. US Bureau of the Census. . QT-02. Profile of Selected Social Characteristics . Washington, DC: US Bureau of the Census; 2000; Available at: http://factfinder.census.gov/servlet/QTTable?ds_name=ACS_C2SS_EST_G00_&geo_id=01000US&qr_name=ACS_C2SS_EST_G00_QT02 Accessed February 14, 2002
  6. US Bureau of the Census. . Language Use and English Speaking Ability: 2000 . Washington, DC: US Bureau of the Census; October 2003; Available at: http://www.census.gov/prod/2003pubs/c2kbr–29.pdf Accessed December 15, 2003
  7. US Bureau of the Census. . Profile of the Foreign-Born Population in the United States: 2000 . Washington, DC: US Bureau of the Census; December 2001; Available at: http://www.census.gov/prod/2002pubs/p23–206.pdf Accessed December 15, 2003
  8. Flores G . Culture and the patient-physician relationship: achieving cultural competency in health care . J Pediatr . 2000;136:14–23
  9. Flores G , Rabke J , Pine W , Sabarwhal A . The importance of cultural and linguistic issues in the emergency care of children . Pediatr Emerg Care . 2002;18:271–284
  10. Flores G. The impact of medical interpreter services on the quality of health care: a systematic review Med Care Res Rev. In press
  11. Pachter LM , Weller SC , Baer RD , et al.   Variation in asthma beliefs and practices among mainland Puerto Ricans, Mexican-Americans, Mexicans, and Guatemalans . J Asthma . 2002;39:119–134
  12. Pachter LM , Cloutier MM , Bernstein BA . Ethnomedical (folk) remedies for childhood asthma in a mainland Puerto Rican community . Arch Pediatr Adolesc Med . 1995;149:982–988
  13. Pachter LM , Bernstein B , Osorio A . Clinical implications of a folk illness: empacho in mainland Puerto Ricans . Med Anthropol . 1992;13:285–299
  14. Weller SC , Pachter LM , Trotter RT , Baer RD . Empacho in four Latino groups: a study of intra- and inter-cultural variation in beliefs . Med Anthropol . 1993;15:109–136
  15. Taveras E, Nelson L, Durousseau S, Flores G. Parents' beliefs and practices regarding childhood fever: a study of a multiethnic and socioeconomically diverse sample of parents Pediatr Emerg Care. In press
  16. Lieu T, Finkelstein J, Lozano P et al. Cultural competence, reports to clinicians, and quality of care for Medicaid-insured children with asthma Pediatrics. In press
  17. National Standards for Culturally and Linguistically Appropriate Services in Health Care. Final Report. Washington, DC: US Dept of Health and Human Services, Office of Minority Health Available at: http://www.omhrc.gov/omh/programs/2pgprograms/finalreport.pdf Accessed March 23, 2004
  18. Betancourt JR , Green AR , Carrillo JE . Cultural competence in health care: emerging frameworks and practical approaches. New York, NY: The Commonwealth Fund . Available at: http://www.cmwf.org/programs/minority/betancourt_culturalcompetence_576.pdf Accessed March 23, 2004
  19. Fuentes-Afflick E , Lurie P . Low birth weight and Latino ethnicity: examining the epidemiologic paradox . Arch Pediatr Adolesc Med . 1997;151:665–674
  20. Anderson LM , Wood DL , Sherbourne CD . Maternal acculturation and childhood immunization levels among children in Latino families in Los Angeles . Am J Public Health . 1997;87:2018–2021
  21. Prislin R , Suarez L , Simspon DM , Dyer JA . When acculturation hurts: the case of immunization . Soc Sci Med . 1998;47:1947–1956
  22. Swanson JW , Linskey AO , Quintero-Salinas R , et al.   A binational school survey of depressive symptoms, drug use, and suicidal ideation . J Am Acad Child Adolesc Psychiatry . 1992;31:669–678
  23. Dusenberry L , Epstein JA , Botvin GJ , Diaz T . The relationship between language spoken and smoking among Hispanic-Latino youth in New York City . Public Health Rep . 1994;109:421–427
  24. Velez CN , Ungemack JA . Drug use among Puerto Rican youth: an exploration of generational status differences . Soc Sci Med . 1989;29:779–789
  25. Reynoso TC , Felice ME , Shragg GP . Does American acculturation affect outcome of Mexican-American teenage pregnancy? . J Adolesc Health . 1993;14:257–261
  26. Burgos AE, Schetzina KE, Dixon LB, Mendoza FS. The importance of generational status in examining racial/ethnic disparities in health care in children Pediatrics. In press
  27. Yu SM , Huang ZJ , Singh GK . Health status and health services utilization among US Chinese, Asian Indian, Filipino, and other Asian/Pacific Islander children . Pediatrics . 2004;113:101–107
  28. David RJ , Collins JW . Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites . N Engl J Med . 1997;337:1209–1214
  29. Kaplan JB , Bennett T . Use of race and ethnicity in biomedical publication . JAMA . 2003;289:2709–2716
  30. International Committee of Medical Journal Editors. . Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Updated November 2003 . Available at: http://www.icmje.org/index.html Accessed March 24, 2004
  31. Smedley BD , Stith AY , Nelson AR . Unequal Treatment. Confronting Racial and Ethnic Disparities in Health Care . Washington, DC: The National Academies Press; 2003;
  32. National Healthcare Disparities Report. . Rockville, Md: US Dept of Health and Human Services, Agency for Healthcare Research and Quality; 2003 . Available at: http://qualitytools.ahrq.gov/disparitiesreport/documents/Report%207.pdf Accessed March 24, 2004
  33. Noah BA . The participation of underrepresented minorities in clinical research . Am J Law Med . 2003;29:221–245
  34. Gifford AL , Cunningham WE , Heslin KC . Participation in research and access to experimental treatments by HIV-infected patients . N Engl J Med . 2002;346:1373–1382
  35. Heiat A , Gross CP , Krumholz HM . Representation of the elderly, women, and minorities in heart failure clinical trials . Arch Intern Med . 2002;162:1682–1688
  36. Walsh C , Ross LF . Whether and why pediatric researchers report race and ethnicity . Arch Pediatr Adolesc Med . 2003;157:671–675
  37. Rivara FP , Finberg L . Use of the terms race and ethnicity . Arch Pediatr Adolesc Med . 2001;155:119
  38. Flores G , Fuentes-Afflick E , Carter-Pokras O , et al.   Why ethnicity and race are so important in child health services research today . Arch Pediatr Adolesc Med . 2001;155:1178–1179
  39. Mendoza FS , Ventura SJ , Valdez B , et al.   Selected measures of health status for Mexican-American, mainland Puerto Rican, and Cuban-American children . JAMA . 1991;265:227–232
  40. Carter-Pokras OD , Gergen PJ . Reported asthma among Puerto Rican, Mexican-American, and Cuban children, 1982 through 1984 . Am J Public Health . 1993;83:580–582
  41. Sokol-Katz JS , Ulbrich PM . Family structure and adolescent risk-taking behavior: a comparison of Mexican, Cuban, and Puerto Rican Americans . Int J Addictions . 1992;27:1197–1209
  42. Herrera GA , Zhao Z , Klevens RM . Variation in vaccination coverage among children of Hispanic ancestry . Am J Prev Med . 2001;20(4S):69–74
  43. Arcia E , Keyes L , Gallagher JJ . Indicators of developmental and functional status of Mexican-American and Puerto Rican children . J Dev Behav Pediatr . 1994;5:27–33
  44. Flores G , Bauchner H , Feinstein AR , Nguyen UDT . The impact of ethnicity, income, and parental education on children's health and use of health services . Am J Public Health . 1999;89:1066–1071
  45. Guendelman S , Schwalbe J . Medical care utilization by Hispanic children: how does it differ from black and white peers? . Med Care . 1986;24:925–940
  46. Frayne SM , Burns RB , Hardt EJ , et al.   The exclusion of non-English-speaking persons from research . J Gen Intern Med . 1996;11:39–43
  47. Walsh C , Ross LF . Are minority children under- or overrepresented in pediatric research? . Pediatrics . 2003;112:890–895
  48. Kodish E , Eder M , Noll RB , et al.   Communication of randomization in childhood leukemia trials . JAMA . 2004;291:470–475
  49. Pachter LM , Dworkin PH . Maternal expectations about normal child development in 4 cultural groups . Arch Pediatr Adolesc Med . 1997;151:1144–1150
  50. Cooper LA , Roter DL , Johnson RL , et al.   Patient-centered communication, ratings of care, and concordance of patient and physician race . Ann Intern Med . 2003;139:907–915
  51. Saha S , Komaromy M , Koepsell TD , Bindman AB . Patient-physician racial concordance and the perceived quality and use of health care . Arch Intern Med . 1999;159:997–1004
  52. Kirkman-Liff B , Mondragón D . Language of interview: relevance for research of southwest Hispanics . Am J Public Health . 1991;81:1399–1404
  53. Hu DJ , Covell RM . Health care usage by Hispanic outpatients as a function of primary language . West J Med . 1986;155:490–493
  54. Flores G , Abreu M , Olivar MA , Kastner B . Access barriers to health care for Latino children . Arch Pediatr Adolesc Med . 1998;152:1119–1125
  55. Weinick RM , Krauss NA . Racial/ethnic differences in children's access to care . Am J Public Health . 2000;90:1771–1774
  56. Marks G , Solis J , Richardson JL , et al.   Health behavior of elderly Hispanic women: does cultural assimilation make a difference? . Am J Psych Health . 1987;77:1315
  57. Woloshin S , Schwartz L , Katz SJ , Welch HG . Is language a barrier to the use of preventive services? . J Gen Intern Med . 1997;12:472–477
  58. Manson A . Language concordance as a determinant of patient compliance and emergency room use in patients with asthma . Med Care . 1988;1119–1128
  59. Alpert M , Kesselman M , Marcos L , Urcuyo L . The language barrier in evaluating Spanish-American patients . Arch Gen Psychiatry . 1973;29:655–659
  60. Baxter M , Bucci W . Studies in linguistic ambiguity and insecurity . Urban Health . 1981;36–40
  61. Sarver J , Baker DW . Effect of language barriers on follow-up appointments after an emergency department visit . J Gen Intern Med . 2000;15:256–264
  62. LeSon S , Gershwin ME . Risk factors for asthmatic patients requiring intubation. I. Observations in children . J Asthma . 1995;32:285–294
  63. Lee ED , Rosenberg CR , Sixsmith DM , et al.   Does a physician-patient language difference increase the probability of hospital admission? . Acad Emerg Med . 1998;5:86–89
  64. Gandhi TK , Burstin HR , Cook EF , et al.   Drug complications in outpatients . J Gen Intern Med . 2000;15:149–154
  65. Kravitz RL , Helms LJ , Azari R , et al.   Comparing the use of physician time and health care resources among patients speaking English, Spanish, and Russian . Med Care . 2000;38:728–738
  66. Hampers LC , Cha S , Gutglass DJ , et al.   Language barriers and resource utilization in a pediatric emergency department . Pediatrics . 1999;103:1253–1256
  67. Carrasquillo O , Orav EJ , Brennan TA , Burstin HR . Impact of language barriers on patient satisfaction in an emergency department . J Gen Intern Med . 1999;14:82–87
  68. Morales LS , Cunningham WE , Brown JA , et al.   Are Latinos less satisfied with communication by health care providers? . J Gen Intern Med . 1999;14:409–417
  69. Baker DW , Parker RM , Williams MV , et al.   Use and effectiveness of interpreters in an emergency department . JAMA . 1996;275:783–788
  70. Crane JA . Patient comprehension of doctor-patient communication on discharge from the emergency department . J Emerg Med . 1997;15:1–7
  71. Hayashi D . Guidance memorandum. January 29, 1998. Title VI prohibition against national origin discrimination—persons with limited-English proficiency . Available at: http://www.hhs.gov/progorg/ocr/lepfinal.htm
  72. Baker DW , Parker RM , Williams MV , et al.   Use and effectiveness of interpreters in an emergency department . JAMA . 1996;275:783–788
  73. National Health Law Program and The Access Project. . Language Services Action Kit Interpreter Services in Health Care Settings for People with Limited English Proficiency . Washington, DC: National Health Law Program; 2004; Available at: http://www.healthlaw.org/pubs/2004.ActionKitReprint.pdf Accessed March 29, 2004
  74. Flores G , Gee D , Kastner B . The teaching of cultural issues in U.S. and Canadian medical schools . Acad Med . 2000;75:451–455
  75. Flores G . Providing culturally competent pediatric care: integrating pediatricians, institutions, families, and communities into the process . J Pediatr . 2003;143:1–2
  76. Flores G , Abreu M , Sun D , Tomany SC . Urban parents' knowledge and practices regarding managed care . Med Care . 2004;42:336–345

PII: S1530-1567(05)60312-7

doi: 10.1367/1539-4409(2004)4<276:CEALII>2.0.CO;2

Ambulatory Pediatrics
Volume 4, Issue 4 , Pages 276-282 , July 2004

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