Health and Healthcare Disparities in Children with Cerebral Palsy

Abstract

Health and healthcare disparities or inequities are defined as differences in health and healthcare outcomes within certain populations such as race, ethnicity, socioeconomic status, sexual orientation, geographic location, and/or disability and imply that such differences are unfair or unjust. The concept of health equity implies giving individuals and/or populations the necessary resources necessary to achieve equal outcomes. Children with cerebral palsy (CP) often represent a subgroup within children with special healthcare needs (CSHCN), children with medical complexity, and/or children with disabilities and often have overlapping risk factors for vulnerability. In addition to the level of motor involvement, and the number of medical comorbidities in children with CP, the prevalence of CP is increased by low socioeconomic and minority ethnicity/race status. These factors further independently lead to health and healthcare disparities and can also result in poor healthcare access (due to lack of insurance, transportation, etc.), low English proficiency, and poor health literacy. The greater overlap of these risk factors, the more likely the child with CP is at risk for poor healthcare outcomes. In order to overcome barriers and achieve equitable outcomes, a multilayer approach is required to overcome each risk factor. This approach is outlined using a vulnerability framework model.