Al Chaar Soltan, Yakdan Salim, El Masri Diala, El Masri Jad, Saleh Mustafa, Al Akoum Monifa, Salameh Pascale
Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Doctoral School of Science and Technology, Lebanese University, Beirut, Lebanon.
J Racial Ethn Health Disparities. 2025 Jun 2. doi: 10.1007/s40615-025-02496-5.
Racial and ethnic disparities in healthcare remain a major challenge. We aim to better characterize and understand the ethnic/racial disparities in health literacy, self-perceived health status, and barriers to healthcare access among heart transplant patients.
This study utilized data from the National Institutes of Health (NIH) All of Us Research Program. Surveys were used to collect sociodemographic data, baseline health status, self-perception of health status, health literacy, and access to healthcare among heart transplant patients. Participants were categorized by race into Black/African-American (BAA), Non-White Hispanic (NWH), and White Caucasian (WC). All data extraction was conducted through the All of Us Researcher Workbench, and statistical analyses were performed using R Studio.
Among the 565 patients with heart transplantation, there are 131 BAA, 107 NWH, and 327 WC. Socio-economic status varied among our patients with WC reporting higher education and higher annual income and more likely to own a home compared with BAA and NWH (p < 0.05). Furthermore, BAA and NWH reported worse general health status, quality of life, ability to carry out daily physical activity, and usual social role compared to WC (p < 0.05). Compared to WC, NWH reported higher fatigue and pain score, whereas BAA reported higher emotional problems, less social satisfaction, increased difficulty with physical activity, and higher pain score (p < 0.05). A higher proportion of NWH and BAA compared with WC had barriers to healthcare access in the past 12 months (p < 0.05). When asked about difficulty understanding medical information and the need for health material assistance, the WC cohort had higher proportion responding "Never" compared with BAA and NWH (p < 0.05). Similarly, the WC cohort had higher proportion reporting "Extremely" when inquired about medical form confidence compared with BAA and NWH (p < 0.05).
BAA and NWH had poorer socioeconomic status, perceived their health as worse, reported lower quality of life, and demonstrated lower health literacy compared to WC.
医疗保健中的种族和民族差异仍然是一项重大挑战。我们旨在更好地描述和理解心脏移植患者在健康素养、自我感知的健康状况以及获得医疗保健的障碍方面的种族/民族差异。
本研究利用了美国国立卫生研究院（NIH）“我们所有人”研究计划的数据。通过调查收集心脏移植患者的社会人口统计学数据、基线健康状况、对健康状况的自我认知、健康素养以及获得医疗保健的情况。参与者按种族分为黑人/非裔美国人（BAA）、非白人西班牙裔（NWH）和白人高加索人（WC）。所有数据提取均通过“我们所有人”研究人员工作台进行，并使用R Studio进行统计分析。
在565例心脏移植患者中，有131例BAA、107例NWH和327例WC。我们的患者社会经济状况各不相同，与BAA和NWH相比，WC患者报告的受教育程度更高、年收入更高且更有可能拥有住房（p < 0.05）。此外，与WC相比，BAA和NWH报告的总体健康状况、生活质量、进行日常身体活动的能力以及通常的社会角色更差（p < 0.05）。与WC相比，NWH报告的疲劳和疼痛评分更高，而BAA报告的情绪问题更多、社会满意度更低、身体活动困难增加且疼痛评分更高（p < 0.05）。与WC相比，NWH和BAA在过去12个月中获得医疗保健存在障碍的比例更高（p < 0.05）。当被问及理解医疗信息的困难以及对健康材料援助的需求时，与BAA和NWH相比，WC队列中回答“从不”的比例更高（p < 0.05）。同样，在被问及对医疗表格的信心时，与BAA和NWH相比，WC队列中报告“极其有信心”的比例更高（p < 0.05）。
与WC相比，BAA和NWH的社会经济地位较差，自我感觉健康状况更差，报告的生活质量较低，且健康素养较低。
