Chronic Viral Hepatitis Screening Inequities Across Florida Federally Qualified Health Centers.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2025-03-06 DOI:10.1007/s40615-025-02363-3

Hannah M Cranford, Daniel Parras, Patricia D Jones, Edelise Endemano, Katherine Chung-Bridges, Paulo S Pinheiro

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Abstract

Aim: Examine racial and ethnic inequities in hepatitis C and B virus (HCV and HBV) screening across high-risk populations.

Subject and methods: Chronic HCV and HBV infections can lead to cirrhosis, hepatocellular carcinoma (HCC), and death. Despite universal screening recommendations, < 50% of US adults are tested for these viruses. Populations with lower socio-economic status experience higher rates of viral-related cirrhosis and HCC, which may be reduced through screening and treatment. This study analyzed data from 91,875 patients (2019-2021) at the Health Choice Network, a federally qualified health center in Florida. Logistic regression assessed the determinants of HCV and HBV screening, considering factors such as age, sex, language, and race/ethnicity.

Results: The study population was predominantly female, Hispanic, uninsured, and living below the federal poverty line. Overall, 61.7% had HCV screening, and 43.7% had HBV screening. Haitian Creole-speaking patients (aOR 1.67; 95% CI, 1.50-1.85), Asian (aOR 1.41; 95% CI, 1.26-1.58), Spanish-speaking Hispanic (aOR 1.38; 95% CI, 1.32-1.44), and English-speaking Hispanic patients (aOR 1.12; 95% CI, 1.07-1.18) had higher odds of HCV screening, compared to NH-Whites. Similarly, Haitian Creole-speaking (aOR 1.91; 95% CI, 1.73-2.12), Asian (aOR 1.50; 95% CI, 1.33-1.68), and Spanish-speaking Hispanic patients (aOR 1.23; 95% CI, 1.17-1.29) had higher odds of HBV screening.

Conclusion: For an underserved population context, screening rates were above average, with higher prevalence among historically disadvantaged populations. However, rates remained suboptimal, particularly among NH-Whites, who account for the largest number of HCV-related liver cancers, often linked to injection drug use. Increasing screening, especially among NH-Whites and English-speaking Hispanics for HCV, is crucial for early diagnosis, treatment, and reducing severe liver disease risk, including cirrhosis and HCC.

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佛罗里达州联邦合格医疗中心的慢性病毒性肝炎筛查不公平。

目的：在高危人群中检查丙型肝炎和乙型肝炎病毒（HCV和HBV）筛查中的种族和民族不平等。对象和方法：慢性HCV和HBV感染可导致肝硬化、肝细胞癌（HCC）和死亡。尽管普遍推荐筛查，结果：研究人群主要是女性，西班牙裔，无保险，生活在联邦贫困线以下。总体而言，61.7%的人接受了HCV筛查，43.7%的人接受了HBV筛查。海地克里奥尔语患者(aOR 1.67；95% CI, 1.50-1.85)，亚洲(aOR 1.41；95% CI, 1.26-1.58)，说西班牙语的西班牙裔(aOR 1.38；95% CI, 1.32-1.44)和说英语的西班牙裔患者(aOR 1.12；95% CI, 1.07-1.18)与NH-Whites相比，HCV筛查的几率更高。同样地，海地克里奥尔语(aOR 1.91；95% CI, 1.73-2.12)，亚洲(aOR 1.50；95% CI, 1.33-1.68)，以及说西班牙语的西班牙裔患者(aOR 1.23；95% CI, 1.17-1.29) HBV筛查的几率更高。结论：在服务不足的人群中，筛查率高于平均水平，在历史上处于不利地位的人群中患病率更高。然而，比率仍然不理想，特别是在nh - white中，他们占hcv相关肝癌的最大数量，通常与注射药物使用有关。加强筛查，特别是在nh -白人和说英语的西班牙裔人群中进行HCV筛查，对于早期诊断、治疗和降低严重肝病风险（包括肝硬化和HCC）至关重要。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.