Children of color in the United States receive worse health care compared with white children, according to a recent review published in The Lancet Child & Adolescent Health.

After reviewing several studies examining the quality of care children receive, researchers found widespread inequities across a range of pediatric specialties, including neonatology, primary care, emergency medicine, surgery, developmental disabilities, mental health care and palliative care, NPR reports.

“No matter where you look, there are disparities in care for Black Americans, Hispanic, Latinx, Asian Americans—pretty much every racial and ethnic group that’s not white,” said Nia Heard-Garris, a researcher at Northwestern University and a pediatrician at Lurie Children’s Hospital of Chicago, who oversaw the review, according to NPR.

The greatest disparity concerned pain management. For example, children of color were less likely than white children to receive painkillers for broken bones, appendicitis or migraines.

What’s more, children of color were less likely to get diagnostic imaging and more likely to experience complications related to surgeries, according to the review. Children of color also faced longer wait times at emergency rooms and were less likely to be diagnosed and treated for a developmental disability.

Heard-Garris noted that the children involved in the review had health insurance so lack of insurance couldn’t be the reason for the disparities.

Rather, structural racism in the form of unequal access to healthy housing and economic opportunities and unconscious bias among health care professionals is largely to blame for these disparities.

“Even if you are the most progressive provider, you’re still going to have things that are blinders,” Heard-Garris said.

Researchers emphasized the need for health care policy changes to combat these disparities and improve outcomes for children of color.