Racial and Ethnic Differences in Barriers to Care Among US Adults with Chronic Inflammatory Skin Diseases: A Cross-Sectional Study of the All of Us Research Program
Abstract
BACKGROUND
Research on racial and ethnic differences in barriers to care among patients with chronic inflammatory skin diseases (CISDs) is limited.
OBJECTIVE
To investigate the prevalence of a broad range of barriers to care among patients with CISDs across different racial and ethnic groups.
METHODS
A cross-sectional study was conducted using survey data from participants with CISDs in the All of Us Research Program. Multivariable regression was used to analyze the relationship between race and ethnicity and experiencing the barriers to care.
RESULTS
Our study included 16,986 patients with CISDs. Compared to White patients, Black and Hispanic patients were significantly more likely to delay care because of cost and a broad range of additional structural barriers, including transportation, work, childcare, adult care, living in a rural area, and the lack of healthcare workforce diversity. Associations between race and ethnicity and many of the barriers to care were substantially attenuated after controlling for insurance, income, and education.
LIMITATIONS
The population studied was not a representative sample of US adults and responses were not specific to dermatologic care.
CONCLUSION
Racial and ethnic minority patients, especially Black and Hispanic patients, with CISDs are disproportionately affected by a broad range of barriers to care.
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