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Herrera A, Hall M, Alex Ahearn M, Ahuja A, Bradford KK, Campbell RA, Chatterjee A, Coletti HY, Crowder VL, Dancel R, Diaz M, Fuchs J, Guidici J, Lewis E, Stephens JR, Sutton AG, Sweeney A, Ward KM, Weinberg S, Zwemer EK, Harrison WN. Differences in testing for drugs of abuse amongst racial and ethnic groups at children's hospitals. J Hosp Med 2024; 19:368-376. [PMID: 38383949 DOI: 10.1002/jhm.13305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/13/2024] [Accepted: 01/28/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Racial and ethnic differences in drug testing have been described among adults and newborns. Less is known regarding testing patterns among children and adolescents. We sought to describe the association between race and ethnicity and drug testing at US children's hospitals. We hypothesized that non-Hispanic White children undergo drug testing less often than children from other groups. METHODS We conducted a retrospective cohort study of emergency department (ED)-only encounters and hospitalizations for children diagnosed with a condition for which drug testing may be indicated (abuse or neglect, burns, malnutrition, head injury, vomiting, altered mental status or syncope, psychiatric, self-harm, and seizure) at 41 children's hospitals participating in the Pediatric Health Information System during 2018 and 2021. We compared drug testing rates among (non-Hispanic) Asian, (non-Hispanic) Black, Hispanic, and (non-Hispanic) White children overall, by condition and patient cohort (ED-only vs. hospitalized) and across hospitals. RESULTS Among 920,755 encounters, 13.6% underwent drug testing. Black children were tested at significantly higher rates overall (adjusted odds ratio [aOR]: 1.18; 1.05-1.33) than White children. Black-White testing differences were observed in the hospitalized cohort (aOR: 1.42; 1.18-1.69) but not among ED-only encounters (aOR: 1.07; 0.92-1.26). Asian, Hispanic, and White children underwent testing at similar rates. Testing varied by diagnosis and across hospitals. CONCLUSIONS Hospitalized Black children were more likely than White children to undergo drug testing at US children's hospitals, though this varied by diagnosis and hospital. Our results support efforts to better understand and address healthcare disparities, including the contributions of implicit bias and structural racism.
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Affiliation(s)
- Adriana Herrera
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Matt Hall
- Department of Analytics, Children's Hospital Association, Lenexa, Kansas, USA
| | - Marshall Alex Ahearn
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Arshiya Ahuja
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathleen K Bradford
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Robert A Campbell
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashmita Chatterjee
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hannah Y Coletti
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Virginia L Crowder
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ria Dancel
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Melissa Diaz
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer Fuchs
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jessica Guidici
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emilee Lewis
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John R Stephens
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley G Sutton
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Alison Sweeney
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelley M Ward
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Steven Weinberg
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eric K Zwemer
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wade N Harrison
- Department of Pediatrics, School of Medicine, Division of Pediatric Hospital Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Srikanth N, Weerakoon SM, Mathew MS, Xie L, Messiah SE. Relationship Between Dating Violence and Contraceptive Use Among Texas Adolescents. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:4852-4876. [PMID: 36000420 DOI: 10.1177/08862605221119519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The recent overturning of Roe v. Wade has the potential to adversely impact reproductive health among adolescents experiencing unplanned pregnancies from dating violence. We examined the associations between contraceptive use and dating violence among Texas high schoolers in the years leading up to this new law. Youth Risk Behavior Surveillance System data from Texas 9th to 12th graders from 2011, 2013, 2017, and 2019 were analyzed. Multinomial logistic regression analyses examined the association between contraceptive use and key descriptive predictors (physical and/or sexual dating violence, survey year, age, sex, and race/ethnic group). Eleven percent of Texas adolescents surveyed reported experiencing either physical or sexual dating violence and 2% reported experiencing both types of violence. Those who experienced any dating violence were significantly more likely to report not using contraception versus those who did not experience violence (12.5% vs. 68.3%, p = 0.01). Adolescents who experienced any type of dating violence were more likely to report using hormonal contraception, condom use, or withdrawal versus those who did not experience dating violence. Hispanic adolescents were 63% more likely than their ethnic group counterparts to use no contraception (odds ratio [OR] 1.63; 95% confidence interval [CI] [1.11-2.40]). A significant proportion of Texas adolescents reported experiencing dating violence, and this group also reported higher noncontraception use versus those not experiencing dating violence. Given new strict Texas antiabortion laws, dating violence prevention and contraceptive use promotion to prevent unwanted reproductive outcomes such as sexually transmitted infections or unplanned pregnancies are imperative in this age group.
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Affiliation(s)
- Nimisha Srikanth
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
- Texas A&M University, College Station, TX, USA
| | - Sitara M Weerakoon
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Matthew S Mathew
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Luyu Xie
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Sarah E Messiah
- University of Texas Health Science Center at Houston, Dallas, TX USA
- University of Texas Health Science Center at Houston, Dallas, TX, USA
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