Greater hesitancy found in families living in under-resourced communities, could exacerbate health inequities
During the first wave of the COVID-19 pandemic, nearly one in four families responded that they would be unlikely to bring their child to the Emergency Department if they had an emergency condition, according to a survey from Ann & Robert H. Lurie Children’s Hospital of Chicago published in the journal Academic Emergency Medicine. Greater hesitancy to seek emergency care was found in families living in under-resourced communities, those who rely on public insurance and in families who are Black, Latinx or Asian.
“We observed greater hesitancy to use the Emergency Department among more vulnerable demographic groups who historically showed high utilization of emergency care for their children,” said lead author Michelle Macy, MD, pediatric emergency care specialist at Lurie Children’s and Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “This reluctance to seek care in a real emergency might further exacerbate health inequities.”
The survey was conducted in the first week of May 2020. In March 2020, the Governor of Illinois issued a Stay-at-Home Executive Order limiting healthcare seeking to emergencies and COVID-19 care. While pediatric outpatient care has rebounded since the restrictions were lifted, emergency care continues to lag behind.
“At Lurie Children’s Emergency Department, we are still seeing about half of the patients we would normally expect to see,” said Dr. Macy. “This is concerning, since delays in emergency care may lead to a child’s condition worsening to the point where they require hospital admission. To avoid a true health crisis, children need to be brought in earlier in the course of their illness. If families are ever concerned, they should contact their child’s primary care provider to determine if emergency care is advised. Our Emergency Department is safe and always ready to help.”
The survey included 3,896 families in metropolitan Chicago during the first wave of the COVID-19 pandemic. Overall, 23 percent of families were hesitant to seek emergency care for their child, with greatest hesitancy observed in families from the most under-resourced communities (27 percent) compared to those living in more affluent neighborhoods (19 percent). Among families of color, approximately a third responded that they would be unlikely to bring their child to the Emergency Department. Similarly, about a third of families on public insurance were reluctant to seek emergency care if their child needed it. Among Spanish speakers, 36 percent were hesitant to seek emergency care for their child.
Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 220,000 children from 48 states and 49 countries.