Why Do Black Children Receive Fewer Antibiotics?

Does race come into play when physicians pull out their prescription pads? New research suggests continued bias toward Blacks and Latinos in healthcare.

A new study shows that Black children are less likely to be prescribed antibiotics by the same physician than their non-Black peers. And while researchers note that this may not necessarily be a bad thing—other children may be receiving too many antibiotics—the study does suggest that race comes in to play, either consciously or unconsciously, when physicians pull out their prescription pads.


Researchers at Children's Hospital of Philadelphia (CHOP) looked at the records of 200,000 children seen by 222 doctors at 25 offices in Pennsylvania and New Jersey. They found that Black children were about 25 percent less likely to receive an antibiotic for a respiratory infection than were a group of predominantly white children.

In this case, the disparity may not be such a negative, according to lead researcher Dr. Jeffrey Gerber of CHOP. "We hypothesize that this discrepancy reflects over-prescribing, both for all antibiotics and for the relative proportion of broad-spectrum antibiotics, to non-black patients, rather than under-prescribing to black patients," wrote Dr. Gerber in the journal Pediatrics.

Gerber and the other study authors said that part of the discrepancy might come from parents of white children asking for antibiotics more often, with doctors following that lead.  But according to the Centers for Disease Control, if antibiotics are used too often for things they can't treat—like colds or other viral infections—they can stop working effectively when they are needed.

One of the reasons the researchers conducted this study was to determine whether previous instances of racial or ethnic disparities in care were part of a pattern.  Some of the differential care for children that has been uncovered within the past year includes:

  • Latino children often have undiagnosed developmental delays and have later been found to have autism, according to researchers at the University of California Davis MIND Institute.
  • Black and Latino children with asthma, despite having high rates of asthma compared to white children, are less likely to receive regular care and recommended treatment and are more likely to be hospitalized. The Obama Administration has initiated a task force charged with reducing the environmental risks that contribute to this disparity.
  • Latino children treated for appendicitis at community hospitals were 23 percent more likely to experience appendix perforation than white children, and Asian children were 34 percent more likely than white children to experience appendix perforation, according to a recent study conducted by researchers from UCLA Medical Center. Latino patients treated at children's hospitals were 18 percent more likely to develop this complication than white patients.

As more Blacks and Latinos gain equitable access to care under the Affordable Care Act and as hospitals are reimbursed based on patient outcomes, it will be interesting to see if these patterns change. It's likely that they will.

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