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Ethnicity, child health and paediatric services
  1. Zeshan Qureshi1,
  2. Alexandra Richards2,
  3. Camilla C Kingdon3,
  4. Ian Sinha4,5,
  5. Oluwakemi Lokulo-Sodipe6,
  6. Anna M Rose6
  1. 1 Wolfson College, University of Cambridge, Cambridge, UK
  2. 2 Cardiff University School of Medicine, Cardiff, UK
  3. 3 Neonatology, Evelina London Children's Hospital, London, UK
  4. 4 Respiratory Unit, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  5. 5 Division of Child Health, University of Liverpool, Liverpool, UK
  6. 6 Paediatrics, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr Zeshan Qureshi, Wolfson College, University of Cambridge, Cambridge CB3 9BB, UK; zq228{at}cam.ac.uk

https://doi.org/10.1136/archdischild-2021-323599

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    Introduction

    Paediatricians have a moral obligation to promote the health and well-being of all children. To achieve this, unmet health needs of minoritised ethnic groups must be addressed. Language for describing disadvantaged ethnic groups is evolving. The term ‘minoritised’ is useful in this context, acknowledging active processes at play and that this can occur to majority groups.1 In this article, we describe the role of paediatricians in addressing ethnic health disparities.

    Health disparities

    Infant mortality rate (IMR) is a key indicator of health inequity. In 2019, the IMR in England and Wales was 2.6 times higher in Black Caribbean children compared with white British children. Disparities were also apparent for Bangladeshi, Indian, Pakistani, Black African and mixed-race children.2 Similarly, there are ethnic inequalities for stillbirth and neonatal mortality rates in the UK. Globally, in a review of 415 ethnic groups in 36 low-income and middle-income countries (LAMICs), 25 countries had significant ethnic differences in under-5 mortality rates.3 Minoritised ethnic groups also have a higher morbidity in common paediatric conditions like asthma, diabetes and obesity. This is a small sample of emerging data highlighting the association between minoritised ethnic groups and adverse health outcomes. Three common explanations are: (a) genetic predisposition and biological factors; (b) confounding by socioeconomic factors; and (c) utilisation and quality of care differences.

    Causes of ethnic health discrepancies

    Historically, racial categories have been considered discrete and fixed, based largely on geography and skin colour. However, genomic medicine has highlighted the complexity of human variation. Genetic clustering of traits is not …

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    Footnotes

    • Twitter @drzeshanqureshi, @CamillaKingdon

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests ZQ is a member of the RCPCH EDI committee. CK is the president of the RCPCH.

    • Provenance and peer review Commissioned; externally peer reviewed.