Health Disparities and Their Effects on Children and Their Caregivers During the Coronavirus Disease 2019 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has uncovered long-standing health disparities in marginalized communities, including racial and ethnic minorities and children with underlying medical and social problems. African Americans, Hispanics, and Native Americans have higher rates of COVID-19 infections and deaths than their population percentages in the United States. Unique populations of children, including children with developmental disabilities, children in the foster care system, children with chronic medical problems, and children who are homeless are particularly vulnerable to COVID-19 infection. This article explores how the COVID-19 pandemic superimposed on health disparities directly and indirectly affects children, adolescents, and their caregivers.

Impact of a 50-Year Premedical Postbaccalaureate Program in Graduating Physicians for Practice in Primary Care and Underserved Areas.

PURPOSE: To evaluate the effectiveness of Wayne State University School of Medicine's (WSUSOM's) 50-year premedical postbaccalaureate program (PBP)-the first and oldest in the United States-in achieving its goals, as measured by medical school matriculation and graduation, primary care specialization, and current practice location. METHOD: A retrospective study of a complete comparative dataset of 9,856 WSUSOM MD graduates (1979-2017) was performed in July-August 2018. This included 539 graduates who were admitted to the PBP between 1969 and 2012. Data collected included PBP students' sociodemographics, postgraduate specialization, residence location at time of admission to the PBP, and current medicine practice location. Health professional shortage areas (HPSAs) and medically underserved areas/populations (MUA/Ps) were determined for residence at admission to the PBP and current medicine practice location. RESULTS: Of the 539 PBP students, 463/539 (85.9%) successfully completed the PBP and matriculated to WSUSOM. Of those, 401/463 (86.6%) obtained an MD, and of those, 233/401 (58.1%) were female and 277/401 (69.1%) were African American. Average investment per PBP student was approximately $52,000 and for an MD graduate was approximately $77,000. The majority of PBP MD graduates with current practice information resided in HPSAs or MUA/Ps at admission to PBP (204/283, 72.1%) and were currently practicing in HPSAs or MUA/Ps (232/283, 82.0%), and 139/283 (49.1%) became primary care physicians (PCPs). Comparison of WSUSOM PBP and non-PBP MD graduates showed PBP physicians become PCPs and practice in HPSAs or MUA/Ps at higher rates than non-PBP physicians (P < .001). CONCLUSIONS: The PBP was successful in graduating a large proportion of physicians from socioeconomically disadvantaged and diverse backgrounds, who practice as PCPs and who practice in HPSAs and MUA/Ps, thereby accomplishing the PBP's goals of helping to address the broad health care needs of all people in the United States.

The use of folk remedies among children in an urban black community: remedies for fever, colic, and teething.

BACKGROUND: Folk remedy use is universal, occurring in all cultures. Folk remedies have been and still are relied on in the black community. In this study, folk remedies refer to herbs, over-the-counter medications, and items traditionally used for cooking that are used to treat a variety of ailments. OBJECTIVE: To identify folk remedies used to treat fever, colic, and teething among black children in Detroit, Michigan. METHODS: Structured interviews were conducted with caregivers of healthy black children <2 years of age who were patients of the general pediatric clinic at Children's Hospital of Michigan. Descriptive analysis of the frequency distribution of the responses was performed. RESULTS: One hundred seven caregivers agreed to participate. All participants were familiar with the use of folk remedies. Most caregivers learned of these remedies from their mothers or grandmothers. Older parents were more likely to use folk remedies, but there was no difference in remedy use among different levels of maternal education. CONCLUSIONS: The knowledge and use of folk remedies were active in this black community. Their use seems to be cultural, rather than attributable to decreased access to health care. Physicians should be aware of these remedies, to educate families about remedies that may be harmful. Most remedies used pose no threat to health. In some cases, remedies may be blended with traditional medical treatments to ensure better patient compliance.