Demographic Disparities Exist Among Children with Otitis Media

What are the current racial/ethnic and socioeconomic disparities in the prevalence of frequent ear infections (FEI) among children in the U.S.?

Background: There has been an increase in the prevalence of otitis media reported in the U.S. in the 1980s and 1990s. An understanding of the size and distribution of the population of children with FEI is important because these patients often require more invasive and costly treatments.

Study design: Cross-sectional study

Setting: Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston; University of California, Los Angeles; and Brigham and Women’s Hospital, Boston

Synopsis: Researchers used the National Health Interview Survey from 1997 to 2006 to evaluate children reported by parents or guardians to have had three or more ear infections during a 12-month period. Researchers evaluated age, sex, race/ethnicity, income level and insurance status using multivariate analysis to determine the influence of demographic variables on the prevalence of FEI.

A limitation of the study was that the data set is based on parent-reported presence of ear infection rather than on medical records and physician diagnosis. Additionally, the survey was not designed to differentiate among the different types of ear infections, nor can it verify the self-reported race/ethnicity status. Nonetheless, the authors found that FEI was more commonly reported in white and Hispanic children than in black children and children of other races or ethnic groups. Furthermore, a larger portion of children in households below the poverty level reported FEI. Black, Hispanic and other races and ethnic groups had a decreased odds ratio for FEI relative to white children; income below poverty level predicted FEI, but lack of insurance coverage did not.

Bottom line: Despite increasing awareness, notable racial/ethnic and socioeconomic disparities exist among children with FEI, indicating a need for efforts to eliminate these disparities and improve care.

Citation: Vakharia KT, Shapiro NL, Bhattacharyya N. Demographic disparities among children with frequent ear infections in the United States. Laryngoscope. 2010;120(8):1667-1670.

—Reviewed by Sue Pondrom