Racial/Ethnic and Linguistic Disparities in Self-reported Health-Related Quality of Life Among Children Undergoing Elective Surgery

Paulina S Lim; Michelle A Fortier; Sherrie H Kaplan; Sergio Gago Masague; Zeev N Kain

doi:10.1007/s40615-025-02468-9

Racial/Ethnic and Linguistic Disparities in Self-reported Health-Related Quality of Life Among Children Undergoing Elective Surgery

J Racial Ethn Health Disparities. 2025 May 7. doi: 10.1007/s40615-025-02468-9. Online ahead of print.

Authors

Paulina S Lim^{1

2

3}, Michelle A Fortier^{4

5

6}, Sherrie H Kaplan^{7

8}, Sergio Gago Masague⁹, Zeev N Kain^{10

4

6}

Affiliations

¹ Department of Anesthesiology and Perioperative Care, University of California, 3800 W. Chapman Ave, Suite 7300, Orange, CA, 92868, USA. palim1@hs.uci.edu.
² UC Irvine Center on Stress and Health, University of California Irvine, 505 S. Main Street, Ste 940, CA, USA. palim1@hs.uci.edu.
³ Children's Hospital of Orange County, Orange, CA, USA. palim1@hs.uci.edu.
⁴ UC Irvine Center on Stress and Health, University of California Irvine, 505 S. Main Street, Ste 940, CA, USA.
⁵ Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA.
⁶ Children's Hospital of Orange County, Orange, CA, USA.
⁷ Health Policy Research Institute, University of California, Irvine, CA, USA.
⁸ Department of Medicine, University of California, Irvine, CA, USA.
⁹ Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, USA.
¹⁰ Department of Anesthesiology and Perioperative Care, University of California, 3800 W. Chapman Ave, Suite 7300, Orange, CA, 92868, USA.

PMID: 40335849
DOI: 10.1007/s40615-025-02468-9

Abstract

Objective: This study examines disparities in self-reported HRQoL among English-speaking non-Latinx White, English-speaking Latinx, and Spanish-speaking Latinx children ages 4-12 years undergoing surgery.

Design: A total of 357 children completed the Child Health Rating Inventories, an animated, computer-administered method, to measure overall, physical, and mental health, as well as pre-operative anxiety. A multivariate general linear model was used to analyze the main effects of race/ethnicity and language on self-reported HRQoL.

Results: Results demonstrated differences in child self-reported overall [F(2,311) = 3.11, p = 0.05)] and mental health F(2,311) = 3.56, p = 0.03)], and preoperative anxiety F(2,311) = 5.70, p = 0.004)] by race/ethnicity and language. Post hoc comparisons using the Bonferroni test indicated that English-speaking Latinx children reported significantly poorer overall (p = 0.04) and mental health (p = 0.04) compared to English-speaking non-Latinx children. English-speaking and Spanish-speaking Latinx children reported significantly higher preoperative anxiety (p = 0.004 and p = 0.02, respectively) compared to English-speaking non-Latinx White children.

Conclusion: Latinx children from English-speaking households as young as 4 years old reported their overall and mental health to be poorer compared to Non-Latinx White children from English-speaking households. Latinx children, regardless of spoken language, reported higher preoperative anxiety compared to non-Latinx White children. These findings highlight the need to consider early childhood experiences in understanding health disparities. Factors such as family dynamics, acculturative stress, and access to healthcare resources could potentially account for disparities in young children's health experiences.

Keywords: Child self-report; Health-related quality of life; Latinx health paradox; Quality of life.