Disparities in Postmastectomy Breast Reconstruction Among American Indian and Alaska Native Women: A Systematic Literature Review and Meta-analysis.

Disparities in healthcare access and outcomes are well documented among racial and ethnic minority groups in the USA, with American Indian/Alaska Native (AI/AN) women experiencing significant barriers to postmastectomy breast reconstruction. This systematic review and meta-analysis of 11 studies highlights these disparities, revealing that AI/AN women are significantly less likely to undergo reconstruction compared with non-Hispanic white women (pooled OR 0.47, 95% CI 0.34-0.66). Contributing factors include geographic isolation, socioeconomic barriers, limited access to reconstructive surgeons, and cultural influences shaped by historical trauma and systemic inequities. Geographic and financial challenges are compounded by inadequate healthcare infrastructure and low rates of culturally sensitive outreach. Addressing these disparities requires targeted interventions such as enhanced healthcare access in rural areas, policy reforms to improve insurance coverage, and culturally tailored patient education initiatives.