Primary language of parent is associated with disparities in pediatric preventive care

Objectives

To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English.

Study design

We conducted a retrospective cohort study of all 38,793 1-year-old Medicaid-enrolled infants born in Washington state between January 1, 1999 and September 30, 2000. The main exposure was self-reported primary language of parents. Using multivariate regression, we estimated the relative risk of receiving appropriate and timely receipt of preventive care visits in the first year as recommended by the American Academy of Pediatrics and Washington state Medicaid.

Results

Fewer than 1 in 6 (15.4%) infants received all 6 recommended preventive care visits in their first year of life. Infants of parents whose primary language was not English were half as likely to receive all recommended preventive care visits compared with infants of parents whose primary language was English (adjusted relative risk = 0.53; 95% confidence interval = 0.49 to 0.58). This disparity was seen in white, Hispanic, and African-American infants, but not in Asian-American infants.

Conclusions

Disparities based on primary language exist in receipt of recommended pediatric preventive care in white, Hispanic, and African-American infants enrolled in Medicaid.

Abbreviations:  AAP, American Academy of Pediatrics , ARR, Adjusted relative risk , CI, Confidence interval , CPT-4, Current Procedural Terminology, Fourth Revision , EPSDT, Early and Periodic Screening, Diagnostic, and Treatment , ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification