Researchers puzzled by racial disparity in ear infection diagnoses

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SALT LAKE CITY -- University of Utah medical researchers are trying to explain a puzzling observation about how children are diagnosed during visits to the doctor.

Doctor Adam Hersh conducts research on infectious diseases and pediatrics at the University of Utah.

He said when it comes to diagnosing children and prescribing them medication - an odd statistic stands out.

“We knew from previous research that there seemed to be a difference in the rate at which black children were diagnosed with ear infections compared to children of other races, predominantly white children,” Hersh said.

Data indicates children of African-American descent are diagnosed 30 percent less often than white children, even though children from both races visit the doctor at equal rates.

Hersh said it’s a problem of over-diagnosis.

“The problem is when ear infections are over-diagnosed, children are treated with antibiotics that they really don’t need, and exposed to the potential harms and side effects of those medications,” he said.

Hersh said overexposure to antibiotics slowly makes children resistant to them.

“Repeated exposure to antibiotics changes the type of bacteria that live in their bodies, and does seem to be linked to long-term health problems,” Hersh said.

Researchers said they're currently at a loss to explain how race is a factor, but one theory about parenting styles could explain why a doctor would over-prescribe.

“Parents have an expectation or a strong desire when they come to see the doctor that the best course of action for their child would be to have an antibiotic prescription,” Hersh said. "Doctors can be influenced by their perception of what parents' expectations are from the office visit."

Though the study doesn't fully explain the race factor, Hersh said he draws one conclusion.

"A really important message from this study is that we need to be really careful and really stringent in how we make the diagnosis of an ear infection, because there’s such a tight link between making that diagnosis and subsequently prescribing an antibiotic.'”