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University of Iowa News Release


June 18, 2009

Report examines racial disparities in children's health care in Iowa

In a recent report, the University of Iowa Public Policy Center (PPC) and the Iowa Department of Public Health (IDPH) investigated how race and ethnicity are related to children's health disparities in Iowa. The research team found that children with Spanish-speaking parents were most likely to report problems accessing medical and dental care.

This report is based on data from the Iowa Child and Family Household Health Survey, which was completed in 2005. Researchers conducted telephone interviews with more than 3,600 families with children in Iowa, including a special sampling of Hispanic and African-American families. The telephone interviews were conducted by the University of Northern Iowa's Center for Social and Behavioral Research. In April, The IDPH and the PPC released the latest report from this study, focusing on racial and ethnic differences in children's health care needs.

"While other recent evaluations of children's health care in Iowa have been very positive overall, this study indicates there are still pockets of children who need our attention. This should concern policy makers in the state, and further study and action is needed to make sure all Iowa children have the same chance of growing up successfully and healthfully," said Jane Borst, bureau chief of the Bureau of Family Health in the IDPH.

According to the survey, children whose parents completed the interview in Spanish had the lowest overall health and oral health status. It is believed that choosing to complete the interview in Spanish may indicate respondents who are less acculturated to Iowa and the health care system. Also, parents in this group were less likely to believe their children were in need of medical care. These children were significantly more likely to be uninsured (almost one in three) and rated their insurance lower if they did have coverage.

"We found that the parents who did the interview in Spanish weren't as familiar with the health care systems in Iowa or in the United States. The language differences appear to have created barriers to children receiving insurance coverage and health care in Iowa," said Pete Damiano, director of the PPC.

On the other hand, children with Spanish-speaking parents were more likely to have healthier habits such as being more physically active and spending less time watching TV or being on the computer. They were also more likely to have had counseling in preventative health care and were less likely to have behavioral problems, the report concluded.

The survey found that African-American children were most likely to have public insurance coverage and also most likely to have dental insurance, in part because Medicaid and hawk-i both provide dental coverage while not all private plans do. They were also most likely to be in a household with higher parenting stress, be in a single parent household, and have the highest rates of asthma, and were least likely to weigh the "right amount" as assessed by parents.

Damiano explained that these survey results should be interpreted carefully, however, as other factors could also be affecting children's health care in Iowa. "Children in this study were grouped by race/ethnicity. Other factors that could influence the results were not included, such as poverty, geographic region or available health care resources," he explained.

Damiano and Borst cited several areas for further research, such as language choice, implications of the findings for the health care workers, and how cultural differences impact decisions on when to seek care, as well as several other social and environmental factors.

For the complete report, see

STORY SOURCE: University of Iowa News Services, 300 Plaza Centre One, Iowa City, Iowa 52242-2500

MEDIA CONTACTS: Peter Damiano, UI Public Policy Center, 319-335-6800; Jane Borst, Iowa Department of Public Health, 515-281-3826; George McCrory, University News Services, 319-384-0012,