Child Emergency Room Visits

The rate at which children and youth 19 and under who reside in the City of St. Louis visit emergency rooms for treatment of a disease or injury

Equity Score
27
Indicator scores are represented on a scale from 1 to 100.
Disparity Ratio
4.03
Disparity direction: black-white
Emergency room visits per 1,000 children 19 and under

Black children are more than four times as likely as white children to visit an emergency room for care.

Source: Missouri Department of Health and Social Services

A score of 100 represents racial equity, meaning there are no racial disparities in outcomes between black and white populations. The lower the Equity Score, the greater the disparity.

For Child Emergency Room Visits, a score of 100 — a score reflecting racial equity — would mean black and white children are equally likely to visit the emergency room for treatment of disease or injury. It is important to note that for this indicator, equity is not our only goal: we also want to improve outcomes for all. 

More Information

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What does this indicator measure?

Child Emergency Room Visits measures the rate at which children and youth 19 and under who reside in the City of St. Louis visit emergency rooms for treatment of a disease or injury. In 2015, there were 46,829 emergency room visits by children, which translates to an emergency room visit rate of 658 per 1,000 children.

Child Emergency Room Visit Analysis

Emergency room visits per 1,000 children 19 and under in St. Louis City.

  All Black White Disparity Ratio Equity Score
Child emergency room visits 46,829 36,818 5,577 - -
Emergency room visits per 1,000 children 657.8 866.1 214.8 4.032 to 1 27

Data Source: Missouri Department of Health and Senior Services Emergency Room MICA, 2015.

Data Note: It is important to note that the data reported is a count of emergency room visits, not visits by unique children. Rates for this indicator are provided by MICA and are age-adjusted based on 2000 standard population.

What does this analysis mean?

Black children are four times as likely as white children to visit an emergency room for care. Annually, there are 866 visits per 1,000 black children, compared to 215 visits per 1,000 white children. If black children visited the emergency room at the same rate as white children, they would have had 27,688 fewer emergency room visits in 2015.

For both black and white children, the shared most common reasons for visiting the emergency room include respiratory distress, injuries and poisonings, and nervous system problems. However, black children visit at higher rates for nearly all causes. Black children are nearly six times as likely as white children to visit an emergency room for skin issues (inflammation, infections, and ulcers), over five times as likely for infection, and nearly five times as likely for respiratory distress. 

Why do Child Emergency Room Visits matter?

The disparate rates of emergency room visits for children, across nearly every illness and injury, suggest that black children are more likely than white children to experience conditions that are harmful to their health. The Ferguson Commission highlighted that emergency room use is tied to people having to delay or forgo needed care because of a lack of health insurance. However, nearly all children in St. Louis are covered by health insurance (96.3%). This suggests that, though insured, black children may not be getting the preventative care that they need, for reasons that could include lack of primary care physicians, limited ability for parents to take time off of work, or limited awareness that preventative care is covered by health insurance. The preventative healthcare that black children do receive is not enough to prevent high rates of emergency room use.

Which Calls to Action from the Ferguson Commission report are linked with this indicator?

The Ferguson Commission report identifies multiple calls to action to expand health insurance coverage and increase access to care. In part, these calls to action aim to reduce reliance upon emergency rooms as sources of primary care. The calls to action are: 

Questions for further investigation

  • Why is there a racial disparity in Child Emergency Room Visits? 
  • What can St. Louis do to reduce racial disparities in Child Emergency Room Visits?
  • What initiatives are currently underway to reduce racial disparities in Child Emergency Room Visits?

How can I learn more about this issue?

In 2015, For the Sake of All, a Washington University in St. Louis-based initiative, published a report on the health and well-being of African Americans in St. Louis. The Regional Health Commission produces an annual "Access to Care" data book which reviews community-wide progress toward strengthening the healthcare safety net system in the region.

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