Racial and Ethnic Disparities in Dry Eye Diagnosis and Care

被引:14
作者
Cui, David [1 ,2 ]
Mathews, Priya M. [1 ]
Li, Gavin [5 ]
Guo, Lee [1 ]
VanCourt, Shanna [1 ]
Saldanha, Ian J. [3 ,4 ]
Karamursel Akpek, Esen [1 ]
机构
[1] Johns Hopkins Univ, Sch Med, Wilmer Eye Inst, Ocular Surface Dis Clin, Baltimore, MD 21205 USA
[2] Sinai Hosp, Krieger Eye Inst, 2401 W Belvedere Ave, Baltimore, MD 21215 USA
[3] Brown Univ, Sch Publ Hlth, Dept Hlth Serv Policy & Practice, Ctr Evidence Synth Hlth, Providence, RI 02912 USA
[4] Brown Univ, Sch Publ Hlth, Dept Epidemiol, Providence, RI 02912 USA
[5] Icahn Sch Med Mt Sinai, New York, NY 10029 USA
关键词
Dry eye; socioeconomic status; race; minorities; treatment; UNITED-STATES; TREATMENT RECOMMENDATIONS; HEALTH DISPARITIES; PAIN; SYMPTOMS; BIAS;
D O I
10.1080/09286586.2022.2131834
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose To investigate health disparities in racial and ethnic minorities with dry eye. Methods Medical records were reviewed for demographics, socioeconomic factors, treatments, and objective dry eye parameters. Race/ethnicity was self-reported as delineated by the U.S. Census. The reference group comprised of randomly selected White patients, with number equal to the largest minority group. Results The study included 465 patients (157 Black, 157 White, 85 Asian, and 66 Hispanic). Compared to White (3.2%) patients, larger proportion of minorities used Medicaid or lacked health insurance (Black 8.3%, P = .054; Asian 10.6%, P = .019; Hispanic 18.2%, P < .001). Black and Hispanic patients had lower estimated median household income than Whites (White $98,472, Black $75,554, P < .001; Asian $105,503, P = .088; Hispanic $86,839, P = .030). Prior to presentation, fewer minority patients received prescription treatments or procedures (White 61.8%; Black 30.6%, P < .001; Asian 43.5%, P = .006; Hispanic 43.9%, P = .014). Although at baseline visit minorities had worse mean conjunctival (White, 1.7; Black 2.2, P = .136, Asian 2.4, P = .022; Hispanic 2.6, P = .005) and corneal staining scores (White, 1.6; Black 2.5, P < .001; Asian 2.3, P = .003; Hispanic 2.4, P = .001), no differences were noted at final visit. Conclusion Minorities presented with worse objective dry eye parameters, and less prior dry eye care. Income and health care access may not fully explain the observed undertreatment at presentation. Differential management by eye care providers and patient attitudes warrant further investigation.
引用
收藏
页码:484 / 491
页数:8
相关论文
共 34 条
[1]   Evaluation of Patients With Dry Eye for Presence of Underlying Sjogren Syndrome [J].
Akpek, Esen Karamursel ;
Klimava, Alena ;
Thorne, Jennifer E. ;
Martin, Don ;
Lekhanont, Kaevalin ;
Ostrovsky, Ann .
CORNEA, 2009, 28 (05) :493-497
[2]   Racial and Ethnic Disparities in Pain: Causes and Consequences of Unequal Care [J].
Anderson, Karen O. ;
Green, Carmen R. ;
Payne, Richard .
JOURNAL OF PAIN, 2009, 10 (12) :1187-1204
[3]  
[Anonymous], US
[4]   Variability of Tear Osmolarity in Patients With Dry Eye [J].
Bunya, Vatinee Y. ;
Fuerst, Nicole M. ;
Pistilli, Maxwell ;
McCabe, Bridgette E. ;
Salvo, Rebecca ;
Macchi, Ilaria ;
Ying, Gui-Shuang ;
Massaro-Giordano, Mina .
JAMA OPHTHALMOLOGY, 2015, 133 (06) :662-667
[5]   Comprehensive profiling of Asian and Caucasian meibomian gland secretions reveals similar lipidomic signatures regardless of ethnicity [J].
Butovich, Igor A. ;
Suzuki, Tomo ;
Wojtowicz, Jadwiga ;
Bhat, Nita ;
Yuksel, Seher .
SCIENTIFIC REPORTS, 2020, 10 (01)
[6]   Ethnic differences between the Asian and Caucasian ocular surface: A co-located adult migrant population cohort study [J].
Craig, Jennifer P. ;
Lim, Joevy ;
Han, Alicia ;
Tien, Leslie ;
Xue, Ally L. ;
Wang, Michael T. M. .
OCULAR SURFACE, 2019, 17 (01) :83-88
[7]   TFOS DEWS II Definition and Classification Report [J].
Craig, Jennifer P. ;
Nichols, Kelly K. ;
Akpek, Esen K. ;
Caffery, Barbara ;
Dua, Harminder S. ;
Joo, Choun-Ki ;
Liu, Zuguo ;
Nelson, J. Daniel ;
Nichols, Jason J. ;
Tsubota, Kazuo ;
Stapleton, Fiona .
OCULAR SURFACE, 2017, 15 (03) :276-283
[8]   Novel Approaches to Advance Minority Health and Health Disparities Research [J].
Duran, Deborah G. ;
Perez-Stable, Eliseo J. .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2019, 109 :S8-S10
[9]   Race, ethnicity, culture, and disparities in health care [J].
Egede, LE .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2006, 21 (06) :667-669
[10]   Large Disparities in Receipt of Glaucoma Care between Enrollees in Medicaid and Those with Commercial Health Insurance [J].
Elam, Angela R. ;
Andrews, Chris ;
Musch, David C. ;
Lee, Paul P. ;
Stein, Joshua D. .
OPHTHALMOLOGY, 2017, 124 (10) :1442-1448