Risks of medical and developmental delays and associated factors among children from different racial and ethnic groups in Kalamazoo County of Michigan, United States.

Background: Medical and developmental risks in early childhood are unevenly distributed across racial and ethnic groups, contributing to persistent health inequities, especially in preschool-aged children. This study assesses the prevalence of medical and developmental risks and delays among children aged 0-5 years from low-income families across different racial groups in Kalamazoo County, Michigan. Methods: A retrospective cross-sectional study among 10,570 children under five years old, utilizing data from local healthcare and community service providers. Descriptive statistics, chi-square tests, and logistic regression were performed to explore associations between racial and ethnic backgrounds and various outcomes, including medical and developmental risks and delays, with significance set at Results: The prevalence of medical risk and delay was 54.5% and 7.0% while developmental risk and delay were 13.3% and 6.7%, respectively. Male gender, minority status, younger age, and multiple diagnoses significantly increased the likelihood of both medical and developmental risks. Minority children were 1.3 times more likely to experience medical risks and 1.2 times more likely to experience developmental risks compared to children in the majority group. Black children had 11 times higher odds (AOR = 11.1; 95% CI = 4.8-25.8) and children from the "Other" racial group had 13 times higher odds (AOR = 13.0; 95% CI = 5.9-28.7) of experiencing medical delays compared to White children. Additionally, Black children had higher odds of experiencing developmental delays than White children (AOR = 1.2; 95% CI = 1.0-1.5). Conclusion: Our study shows that Black children and children from other racial groups are much more likely to encounter medical and developmental challenges compared to White children. These disparities suggest that race, socioeconomic status, and early childhood interventions play a crucial role in influencing medical and developmental outcomes. Addressing these inequities requires targeted policies, such as early screenings, expanded healthcare access, and culturally competent care, to improve health outcomes for minority children in underserved communities. Strengthening early developmental screening, improving continuity of primary care, and guaranteeing timely interventions for high-risk children may further reduce these conditions in this population.