Non-White children in the US receive lower-quality health care, including in emergency settings, where they are less likely to get painkillers for broken bones and migraines, according to a review of recent medical research. From neonatal and primary care, to surgery and endocrinology, the quality of pediatric health care is almost universally worse for non-White children, regardless of their insurance status, according to research published Wednesday in the Lancet Child & Adolescent Health Journal. (Also read: Covid variant JN.1 spreading fast; preventive tips for children)

While the extent of lower-quality health care for racial minorities varies across specialties, there’s a large body of evidence that shows emergency medicine and mental health care are unequal, researchers, who reviewed studies between January 2017 and July 2022, found.

The researchers, a group of scientists from Harvard University, Johns Hopkins University and other US universities, said federal and state policies that cause systemic racial inequality contribute to differences. For example, immigration rules make it harder for some children to access public benefits, they said. And housing policies that have led to racially segregated neighborhoods are linked to worse health outcomes for non-White children.

“It is not by accident we’re seeing disparities in almost every specialty,” said Nia Heard-Garris, the study’s senior author and pediatrician at the Feinberg School of Medicine at Northwestern University. “There is a structural underlying institutional and systemic problem.”

Racial minorities face longer wait times and are more likely to leave the ER without antibiotics or IV fluids. Non-White kids are also less likely to be diagnosed with a developmental delay or receive treatment for depression or attention-deficit/hyperactivity disorder.

The differences start at the earliest phases of life and extend until death, the data show. Black, Hispanic and Asian children that receive palliative care are more likely to die in the hospital, according to the study.

Authors of the study recommend expanding access to Medicaid and the Children’s Health Insurance Program (CHIP). They also said the US should improve the social and economic conditions of segregated neighborhoods and incarcerate children only as a last resort.

“The thing I would love to see the most is multi-sector partnerships: patients, patient advocacy organizations, hospitals, policymakers and even business to come together to help tackle these really wicked problems,” Heard-Garris said.