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The Health of Latino Children
Urgent Priorities, Unanswered Questions, and a Research Agenda
Glenn Flores, MD;
Elena Fuentes-Afflick, MD, MPH;
Oxiris Barbot, MD;
Olivia Carter-Pokras, PhD;
Luz Claudio, PhD;
Marielena Lara, MD, MPH;
Jennie A. McLaurin, MD, MPH;
Lee Pachter, DO;
Francisco Ramos Gomez, DDS, MPH;
Fernando Mendoza, MD, MPH;
R. Burciaga Valdez, PhD;
Antonia M. Villarruel, PhD;
Ruth E. Zambrana, PhD;
Robert Greenberg, MD;
Michael Weitzman, MD
JAMA. 2002;288:82-90.
Latinos recently became the largest racial/ethnic minority group of
US children. The Latino Consortium of the American Academy of Pediatrics Center
for Child Health Research, consisting of 13 expert panelists, identified the
most important urgent priorities and unanswered questions in Latino child
health. Conclusions were drawn when consensus was reached among members, with
refinement through multiple iterations. A consensus statement with supporting
references was drafted and revised. This article summarizes the key issues,
including lack of validated research instruments, frequent unjustified exclusion
from studies, and failure to analyze data by pertinent subgroups. Latino children
are at high risk for behavioral and developmental disorders, and there are
many unanswered questions about their mental health needs and use of services.
The prevalence of dental caries is disproportionately higher for Latino children,
but the reasons for this disparity are unclear. Culture and language can profoundly
affect Latino children's health, but not enough cultural competency training
of health care professionals and provision of linguistically appropriate care
occur. Latinos are underrepresented at every level of the health care professions.
Latino children are at high risk for school dropout, environmental hazards,
obesity, diabetes mellitus, asthma, lack of health insurance, nonfinancial
barriers to health care access, and impaired quality of care, but many key
questions in these areas remain unanswered. This article suggests areas in
which more research is needed and ways to improve research and care of Latino
children.
Author Affiliations: Department of Pediatrics,
Boston University Schools of Medicine and Public Health, Boston Medical Center,
Boston, Mass, and Center for the Advancement of Urban Children, Department
of Pediatrics, Medical College of Wisconsin, Milwaukee (Dr Flores); Department
of Pediatrics, University of California, San Francisco, School of Medicine
(Dr Fuentes-Afflick); National Hispanic Medical Association and Soros Advocacy
Fellow, Washington, DC (Dr Barbot); Office of Minority Health, Department
of Health and Human Services, Rockville, Md (Dr Carter-Pokras); Department
of Community Medicine, Mount Sinai School of Medicine, New York, NY (Dr Claudio);
Department of Pediatrics, UCLA School of Medicine, Los Angeles, Calif (Dr
Lara); Migrant Clinician's Network, Austin, Tex (Dr McLaurin); Departments
of Pediatrics and Anthropology, University of Connecticut School of Medicine,
Saint Francis Hospital and Medical Center, Hartford (Dr Pachter); Department
of Health Services Research, University of California, San Francisco, School
of Dentistry (Dr Gomez); Department of Pediatrics, Stanford University School
of Medicine, Palo Alto, Calif (Dr Mendoza); School of Public Health, MCP Hahnemann
University, Philadelphia, Pa, and RAND Health Science Program, Santa Monica,
Calif (Dr Valdez); Division of Health Promotion and Risk Reduction Programs,
School of Nursing, University of Michigan, Ann Arbor (Dr Villarruel); Department
of Women's Studies, University of Maryland, College Park (Dr Zambrana); Department
of Pediatrics, University of New Mexico School of Medicine, Albuquerque (Dr
Greenberg); and Center for Child Health Research and University of Rochester
School of Medicine, Rochester, NY (Dr Weitzman). Authors are the members of
the Latino Consortium of the American Academy of Pediatrics Center for Child
Health Research.
After July 30, 2002, Dr Flores will be with the Center
for the Advancement of Urban Children, Department of Pediatrics, Medical College
of Wisconsin, MACC Fund Research Center, Milwaukee.
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RELATED LETTER
Health Risks of Latino Children
Michael A. Rodríguez, Rosa Solorio, David E. Hayes-Bautista, T. Bella Dinh-Zarr, Elizabeth Heitman, Susan P. Baker, Federico E. Vaca, William Wen, Scott Osberg, Carolyn DiGuiseppi, Beverly Weidmer, Robert Weech-Maldonado, Charles Darby, Leo S. Morales, Joseph H. Davis, Glenn Flores, Elena Fuentes-Afflick, Oxiris Barbot, Olivia Carter-Pokras, Luz Claudio, Marielena Lara, Jennie A. McLaurin, Lee Pachter, Francisco Ramos Gomez, Fernando Mendoza, R. Burciaga Valdez, Antonia M. Villarruel, Ruth E. Zambrana, Robert Greenberg, and Michael Weitzman
JAMA. 2002;288(16):1981-1983.
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