Inequalities in the assessment of childhood short stature

A paper has been published in the British Journal of General Practice highlighting the varied inequalities in the assessment of childhood stature, including systematic gender and racial biases.

As the paper shares; early detection of short stature is key to optimising health outcomes, however, there are significant social disparities in the assessment of childhood short stature.

We have shared some of the key issues raised below. You can read the full paper here.

“There are significant social disparities in the assessment of childhood short stature. This presents additional challenges and it is crucial that clinicians recognise issues relating to gender, race, and poverty to improve timely diagnosis and reduce health inequalities.”

“Girls are less frequently referred from primary care for assessment of short stature, yet often have more severe growth failure at presentation and have higher rates of underlying pathology compared with boys.”

“Bias inherent in health professionals also contributes to disparities in the investigation and treatment of short stature. White children, especially those from higher socioeconomic groups, are not only more frequently referred for concerns about growth but are also more likely to be offered growth hormone (GH) stimulation testing than children of other ethnicities.”

“Although the assessment and treatment of short stature should be driven by clinical concern, biased clinical decision making is disadvantaging girls and some ethnic minority groups, especially Black children. Paradoxically, these groups have the greatest need.”

“These systematic racial and gender biases in clinicians and families are often unconscious, but must be acknowledged and tackled before healthcare inequalities can be addressed.”

“Raising awareness of the health disparities in the assessment of childhood short stature in caregivers, primary, secondary, and specialist clinicians is key to addressing these issues.”

The team at Child Growth Foundation are proactively working on how we can support this work needed to address these inequalities and the challenges these inequalities bring to many children and families.

Two of the paper’s co-authors are CGF’s Medical Advisors, Professor Helen L Storr and Professor Justin Davies, with the paper featuring quotes kindly shared from the CGF community of families. Thanks to them and to all involved in this paper for raising these important issues.

The authors of this paper have also published ‘Assessment of childhood short stature: a GP guide’ which is also available on the British Journal of General Practice.

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