Racial/Ethnic Disparities in Health Literacy, Perception of Health Status, and Access to Healthcare Among Heart Transplant Patients of the National Institutes of Health All of Us Research Program.

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.