Racial and Ethnic Disparities in Degenerative Lumbar Disc Disease: A Population-Based Study Using the All of Us...

Area of Science:

• Orthopedics
• Health Services Research
• Health Equity

Background:

• Degenerative lumbar disc disease (DLDD) is a common cause of low back pain and radicular leg pain.
• Racial and ethnic disparities in DLDD care may impact clinical outcomes but are understudied.

Purpose of the Study:

• To investigate differences in health literacy, access to care, and healthcare utilization among patients with DLDD across racial and ethnic groups.
• To identify disparities in DLDD care using the All of Us (AoU) Research Program database.

Main Methods:

• Adults diagnosed with DLDD were identified from the AoU database.
• Participants were stratified by race and ethnicity (White, Black, Hispanic, Other).
• Comparisons of demographics, socioeconomic status, health literacy (BRIEF score), healthcare access, and treatment utilization were performed using chi-square analyses and multivariate logistic regressions.

Main Results:

• Black and Hispanic participants reported significantly lower health literacy compared to White participants.
• Minority groups were more likely to be denied insurance and face difficulties affording care, medications, and follow-up visits.
• Black participants were more likely to receive nonoperative treatments, including physical therapy, steroid injections, and opioids, compared to White participants.

Conclusions:

• Disparities in DLDD care are multifactorial, influenced by race/ethnicity, age, sex, comorbidities, and social determinants of health.
• Access and affordability barriers persist for minority groups despite Medicare eligibility, indicating issues with underinsurance and coverage gaps.
• Targeted interventions are crucial to improve access, promote education, and ensure equitable DLDD treatment for minority populations.