Sociodemographic drivers of care disparity among patients with inborn errors of immunity

To review the current literature surrounding impact of sociodemographic factors, including race, ethnicity, and socioeconomic status, on care disparities for inborn errors of immunity (IEI).

There is a growing body of literature indicating significant sociodemographic and geographical disparities in diagnosis, management, and clinical outcomes of IEI. Historically underserved populations are more likely to experience underdiagnosis, diagnostic delay, and more severe adverse health events, including more infections and earlier death. Implementation of universal newborn screening and no-cost genetic testing programs have helped address the cost barriers to early diagnosis, representing important steps towards addressing diagnostic disparities in IEI. In parallel, recent advances in artificial intelligence offer promise by enhancing identification of IEI through automated analysis of clinical data. However, significant disparities remain.

This review highlights sociodemographic drivers of care disparities for IEI. More inclusive screening and diagnostic tools, such as use of unbiased molecular and artificial intelligence approaches, may offer critical opportunities to close these gaps for these most vulnerable IEI patient populations.