Impact of race and socioeconomic deprivation on clinical outcomes and healthcare utilization in pediatric multiple sclerosis.
Mult Scler J Exp Transl Clin
; 10(3): 20552173241274586, 2024.
Article
en En
| MEDLINE
| ID: mdl-39193072
ABSTRACT
Background:
Health disparities in adult-onset multiple sclerosis have been identified in the Black/African American (AA) population. A higher relapse rate has been suggested in Black/AA patients with pediatric-onset MS (POMS), but little work explores healthcare utilization and social determinants of health (SDOH).Objective:
To evaluate racial, ethnic, and socioeconomic disparities in POMS outcomes.Methods:
Retrospective chart review identified 31 eligible patients diagnosed with POMS at Children's of Alabama between 2013 and 2023. Demographics, outcomes, and healthcare utilization over 2 years from diagnosis were collected. Patient addresses were connected to SDOH measures from the US Census. Bivariate analysis was performed using Fisher's Exact Test, Wilcoxin Test, and 2-sided t-test.Results:
Black/AA children had a higher Expanded Disability Status Scale (EDSS) at first presentation (p = 0.0276) and were more likely to initiate fingolimod vs. glatiramer acetate (p = 0.0464). Living further from Children's of Alabama was associated with a higher most recent EDSS (p = 0.0301) and fewer neurology appointments (p = 0.0167). Families living in more socioeconomically deprived census tracts had significantly more hospital admissions.Conclusion:
Black/AA POMS patients had a more severe initial presentation and were started on higher efficacy medication. We identified disparities in EDSS and healthcare utilization based on SDOH data linked to a child's home address.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Mult Scler J Exp Transl Clin
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos