To evaluate the association between race/ethnicity, poverty, and mental health in youth with chronic conditions.
A cross-sectional comparative study was performed using the records of a tertiary care center from 2011-2015.
children aged 4-17 years with >1 hospitalization/ED visit.
those with arrhythmias or treatment with clonidine/benzodiazepines.
diagnosis or medication for anxiety, depression, or attention deficit hyperactivity disorder (ADHD). Primary predictor variable: diagnosis of cystic fibrosis (CF), sickle cell disease (SCD), and congenital heart disease (CHD).
112,313 patients were identified, 0.2% with CF, 0.4% with SCD, and 1.0% with CHD. Patients with CF had the highest prevalence (23%) and odds (OR 4.21, 95% CI 3.07-5.77) of anxiety or depression, while patients with SCD had the lowest prevalence (7%) and odds (OR 1.54, 95% CI 1.11-2.14). Those with CHD had a prevalence of up to 17%, with 3-4 times higher odds of anxiety or depression (OR 3.70, 95% CI 2.98-4.61). All non-White participants were less likely to be diagnosed/treated for anxiety or depression and ADHD. While poverty increased the probability of anxiety or depression in patients with CHD, this was not seen in CF or SCD.
Children with CF, SCD, and CHD are at increased risk of anxiety or depression; however non-White patients are likely being under-diagnosed/treated. Increased screening and recognition in minority children are needed to reduce disparities in mental health outcomes.

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