Child Emergency Room Visits

Child Emergency Room Visits measures the number of children age 19 and under who reside in the St. Louis region and visited emergency rooms for treatment of a disease or injury. In 2015, there were approximately 179,512 emergency room visits by children across the four-county region, which translates to an emergency room visit rate of 415.62 per 1,000 children.

Child Emergency Room Visits Indicator Scores

City of
St. Louis

27

St. Louis
County

30

St. Charles
County

50

St. Clair
County

56

Data Source: Missouri Department of Health and Senior Services Emergency Room MICA, 2015; Illinois Center for Health Statistics, 2014

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. Data for St. Clair County includes only children ages 14 and under.

What does this score mean?

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.

WHAT DOES THIS ANALYSIS MEAN?

Black children are nearly three times as likely as white children to visit an emergency room for care. Annually, there are 612 visits per 1,000 black children, compared to 230 visits per 1,000 white children.

If children’s health care in the region was racially equitable, black children would have had approximately:

27,688 fewer visits to the emergency room in the City of St. Louis,
1,188 fewer visits to the emergency room in St. Charles County,
3,709 fewer visits to the emergency room in St. Clair County, and
38,076 fewer visits to the emergency room in St. Louis County in 2015.

For both black and white children, the shared most common diagnoses 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, although 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 health care that black children do receive is not enough to prevent high rates of emergency room use.

WHICH CALLS TO ACTION FROM THE FERGUSON COMMISSION’s REPORT ARE LINKED WITH THIS INDICATOR?

The Ferguson Commission’s 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, Health Equity Works, formerly known as 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 health care safety net system in the region.

Child Emergency Room Visits Data

Emergency room visits per 1,000 children 19 and under

	All	Black	White	Disparity Ratio	Equity Score
Child Emergency Room Visits	46,829	36,818	5,577
Emergency Room Visits per 1,000 Children	657.79	866.06	214.76	4.033 to 1	27

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

Emergency room visits per 1,000 children 19 and under

	All	Black	White	Disparity Ratio	Equity Score
Child Emergency Room Visits	90,068	52,855	29,988
Population	247,630	77,177	156,600
Emergency Room Visits per 1,000 Children	363.72	684.85	191.49	3.576 to 1	30

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

Emergency room visits per 1,000 children 19 and under

	All	Black	White	Disparity Ratio	Equity Score
Child Emergency Room Visits	24,183	2,744	19,466
Population	102,533	7,300	91,315
Emergency Room Visits per 1,000 Children	235.9	375.9	213.2	1.763 to 1	50

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

Emergency room visits per 1,000 children 14 and under

	All	Black	White	Disparity Ratio	Equity Score
Child Emergency Room Visits	-	9,781	8,651
Population	-	22,327	31,809
Emergency Room Visits per 1,000 Children	-	438.10	271.90	1.611 to 1	56

Data Source: IDPH Illinois Center for Health Statistics, 2014

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