Barriers to Health Care Access and Use among Racial and Ethnic Minorities with Noninfectious Uveitis

Abstract

Purpose

To investigate barriers to health care access and use among patients with noninfectious uveitis (NIU) across different racial and ethnic groups.

Design

Retrospective cross-sectional study.

Participants

Participants in the nationwide All of Us Research Program who received a diagnosis of chronic NIU.

Methods

We analyzed the health care access and use (HCA&U) and social determinants of health (SDoH) surveys. Racial and ethnic groups were defined as non-Hispanic White, non-Hispanic Black, Hispanic, and other. Multivariable logistic regression models adjusted for age, sex, education, insurance type, and income were used to assess disparities.

Main Outcome Measures

Financial and nonfinancial disparities in health care access among racial and ethnic groups.

Results

Of 2452 patients with NIU, 810 patients (33%) responded to the HCA&U survey and 607 patients (24.7%) responded to the SDoH survey. Non-Hispanic Black participants reported significantly more experiences of being treated with less courtesy (adjusted odds ratio [aOR], 2.6; 95% confidence interval [CI], 1.4–5; P = 0.003) and respect (aOR, 2.6; 95% CI, 1.4–4.8; P = 0.003), as well as receiving poorer services (aOR, 3.6; 95% CI, 1.9–6.9; P < 0.001) compared with non-Hispanic White participants. Individuals categorized as belonging to other minority groups were more likely to delay seeking medical care because of out-of-pocket costs (aOR, 3.4; 95% CI, 1.6–7.1; P = 0.001) and concerns over medical bills (aOR, 2; 95% CI, 1.05–3.8; P = 0.04). Additionally, they experienced significant delays in care because of living in rural areas with limited access to health care providers (aOR, 7.1; 95% CI, 1.4–35.6; P = 0.02).

Conclusions

Racial and ethnic minorities with NIU face significant barriers to health care use and quality, underscoring the need for targeted interventions to address disparities and improve health equity in uveitis management.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.