Racial/Ethnic Disparities in Perception of Health Literacy and Barriers to Care Among Cervical Stenosis Patients.

Abstract

Study DesignCross-Sectional Survey.ObjectiveThis study aimed to assess racial disparities in self-reported barriers to care, health literacy, and health status within a large cohort of cervical stenosis patients.MethodsThis cross-sectional study used ICD-9 and ICD-10 codes to identify cervical stenosis patients recorded in the NIH All of Us Research Program between 2017 and 2022. Demographic information and self-reported measures of health status, health literacy, and perceived barriers to care were compared among White, Black, and Hispanic patients using Chi square tests.ResultsOf 5480 patients identified, 658 (12.0) were Black, 379 (6.9) Hispanic, and 4443 (81.1) White. White patients were more likely to possess college education (<i>P</i> < .001), income >$50k per year (<i>P</i> < .001), and non-disabled employment status (<i>P</i> < .001). Black and Hispanic patients reported higher levels of 7-10 pain (<i>P</i> < .001), "severe" 7-day fatigue (<i>P</i> < .001), and poor general health (<i>P</i> < .001). Black and Hispanic patients also reported greater difficulties understanding medical information (<i>P</i> < .001) and navigating medical forms alone (<i>P</i> < .001). Black and Hispanic patients were likelier to report delaying care due to unaffordable copays (<i>P</i> < .001), transportation difficulties (<i>P</i> < .001), or dissimilar provider background. Provider background was more likely to be described as "very important" by Black and Hispanic patients (<i>P</i> < .001).ConclusionThis study identified significant disparities in health status, health literacy, and access to care among patients with cervical stenosis, highlighting diverse patient perspectives on barriers to care which may warrant further study.