**Background:** Health disparities, especially ones that highlight racial and socioeconomic differences, continue to be a major problem within the United States. Central precocious puberty (CPP) in females is a condition in which the onset of puberty occurs younger than eight years. Timing of pubertal development varies by race and cultural perception of puberty may differ. Gonadotropin releasing hormone agonists (GnRHa) can aid in delaying pubertal symptoms. We aimed to better understand the relationship between treatment for CPP and insurance type, and treatment for CPP and race.
**Methods:** We retrospectively reviewed medical records of 66 females with CPP treated with GnRHa from ages 3 to 11 years and collected data on patients’ race, insurance type (Medicaid, commercial insurance, or self-pay), medication type (histrelin or leuprolide), age at their first appointment, and length of treatment. CPP diagnostic criteria were breast development at <8 years old, measurable pubertal luteinizing hormone and/or estradiol concentrations, and bone age advancement. Decision on which GnRHa was used depended on the endocrinologist and family’s preference.
**Results:** Mean age was 7.8±1.9 years at first appointment and treatment duration was 2.2±1.4 years. The age at the first appointment was significantly earlier for those with Medicaid (6.8±2.1 years) compared to those with commercial insurance (8.2±1.8 years, _P_<0.05). There was also a significant difference between race and age at first appointment, with non-White patients being seen earlier compared to White patients (7.1±1.9 years versus 8.2±1.9 years, _P_<0.02). There was no significant difference between insurance type and length of GnRHa treatment (_P_=0.60). There was also no association between race and type of GnRHa treatment, or between insurance type and type of GnRHa treatment (both _P_>0.05).
**Conclusion:** A lack of difference in treatment duration or treatment modality demonstrates a commitment to equity of care for all patients regardless of race or insurance coverage. The earlier presentation of non-White patients is consistent with normal racial differences in age of puberty onset. Assessment of treatment practices should occur on a continual basis as it plays an integral part in ensuring quality patient care.

ASSESSMENT OF CENTRAL PRECOCIOUS PUBERTY CARE FOR RACIAL AND SOCIOECONOMIC DISPARITIES

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Icahn School of Medicine at Mount Sinai

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