Minority Fifth Graders Face Health Obstacles, Study Finds

But with similar schools, family income, disparities declined

Wednesday, August 22, 2012

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WEDNESDAY, Aug. 22 (HealthDay News) -- Black and Latino fifth graders in the United States are more likely than white students to be obese, to get too little exercise, to witness violence and to ride without seatbelts and bike helmets, all signs of significant disparities that could put their health and safety at risk, a new study finds.
Yet, despite what researchers characterize as "striking" differences in how black and Latino children are faring compared to whites, their report gives clues about what may lie at the heart of it -- and it's largely not race or ethnicity itself.
Instead, the analysis showed that when household income, family education level and the schools the children attended were taken into account, some of those disparities disappeared.
In other words, a black or Latino child from a similar economic background, attending a similar school and whose parents had an equal level of education did about as well as a white child from the same demographic on many health measures.
"We do find substantial differences in a number of health related experiences, behaviors and outcomes with black and Latino children. Most of the time, they're not doing as well as white children on the various health indicators," said study author Dr. Mark Schuster, chief of general pediatrics at Boston Children's Hospital and a professor of pediatrics at Harvard Medical School. "What happened when we controlled for various factors such as the school, household income and family education level, we found the differences were not as substantial."
The study is published in the Aug. 23 issue of the New England Journal of Medicine.
The study included interviews with more than 5,000 children aged 10 and 11 and their parents in three U.S. metropolitan areas: Birmingham, Ala., Houston and Los Angeles. Researchers measured 16 aspects of health and health-related behavior, and found significant differences between black and white children on all 16 indicators, and significant differences between white and Latino children on 12 of the 16 indicators.
Among the key findings:

About 5 percent of white kids witnessed gun-related threats or violence, compared to 20 percent of black children and 11 percent of Latino children. That makes black children four times more likely and Latino children twice as likely as white kids to see a threat or injury with a gun.
Black fifth graders were more likely to have smoked cigarettes (10 percent) than Latino (6 percent) and white children (5 percent). Black kids were also slightly more likely to have tried alcohol.
About 29 percent of black kids and 32 percent of Latino kids were obese, compared to 17 percent of white kids. Black and Latino kids were less likely than whites to report getting vigorous exercise in the past week.
Nearly half of white children always wore a bike helmet, compared to 14 percent of black children and 18 percent of Latinos children. Black and Latino children were also somewhat less likely than white children to always wear a seatbelt.
Black and Latino children were more likely to report worse overall health.
Discrimination because of race, ethnicity, weight and other issues was more common for black and Latino children than whites.
Black children were victimized by peers more often than Latino or white children.

And yet, when researchers took into account other demographic factors and schools, the differences were much less stark, even largely vanishing between white children and Latino children.
When comparing black and white children at the same school and with relatively equal household income and parental education levels, health disparities were eliminated on six of the 16 measures, and most of the others were substantially less dramatic.
For Latino children, taking into account those other socioeconomic factors, seven health disparities were eliminated. Others were substantially reduced, and on three measures, Latino children fared better than white kids from similar backgrounds. (Those included the likelihood of being victimized by a peer and of perpetrating physical or nonphysical aggression.)
Dr. Sherald Leonard, a pediatrician at Rush University Medical Center in Chicago, said the findings show just how complex the issue of health disparities is, with race, ethnicity, neighborhoods, schools, poverty and multiple other factors potentially playing a part.
"It adds to the growing knowledge that this problem is bigger than race or ethnicity. It's how much you earn. Your neighborhood. Your school. Your experiences. It's so complex," she said.
The study also highlights how important it is to reach kids early in childhood, "to try to make sure every child has the best chance in life for success," Leonard said.
Schuster said he was intrigued about the role of schools. Researchers don't have details about the characteristics of the specific schools, but many schools associated with the most positive effect on children's health behavior were in lower-income neighborhoods.
It's often thought that good schools go hand-in-hand with more affluent communities, and vice versa, but the study suggests that may not be entirely true, he said.
"It's certainly pretty compelling that school has an effect above and beyond neighborhood," Schuster said. "Is it the case teachers who believe in what they're doing, a visionary principal, an engaged parent-teacher organization or a strong commitment to health education can teach kids they do have a future? Schools are a key place to look for those answers."

SOURCES: Mark Schuster, M.D., Ph.D., chief, general pediatrics, Boston Children's Hospital, and professor, pediatrics, Harvard Medical School; Sherald Leonard, M.D., pediatrician, Rush University Medical Center, Chicago; Aug. 23, 2012, New England Journal of Medicine

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