Evidence map›Paper›PMID 40437324›Full record

Observational studySpine deformity2025

Racial, ethnic and socioeconomic disparities in healthcare for adult spinal deformity patients.

Joseph E Nassar, Michael J Farias, Manjot Singh, Andrew Xu, Lama A Ammar, Mohammad Daher, Ashley Knebel, Bassel G Diebo, Alan H Daniels

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Joseph E NassarDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Michael J FariasDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Manjot SinghDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Andrew XuDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Lama A AmmarDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Mohammad DaherDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Ashley KnebelDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Bassel G DieboDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA.
Alan H DanielsDepartment of Orthopedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Avenue, East Providence, RI, 02914, USA. alandanielsmd@gmail.com.ORCID http://orcid.org/0000-0001-9597-4139

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRacial and ethnic disparities in healthcare access remain underexplored among adult spinal deformity (ASD) patients in terms of cost related and non-cost related barriers to care.

methodsThis cross-sectional study analyzed healthcare access and utilization survey data from the National Institutes of Health's All of Us Research Program (May 6th, 2018-January 30th, 2025). The participants included adults aged ≥ 40 years with spinal deformity enrolled online or through partner organizations across the US. The cost and non-cost barriers to health among ASD patients by race and ethnicity were reported. Multivariate logistic regressions were used to analyze the relationship between race and ethnicity and experiencing barriers to care.

resultsThis study included 7272 ASD patients of which 5635 were White (74.5%) (median age, 69 years [IQR, 60.0-75.0]), 535 Hispanic (7.4%) (60.0 years [51.0-68.0]), 538 (7.4%) Black (61.5 years [52.0-69.0]) and 564 (7.8%) of other race and ethnicity (65.0 years [55.0-74.0]) of whom 528 (7.3%) proceeded to undergo correction surgery. Compared to White patients, Black patients had higher odds of reporting delayed general care (adjusted odds ratio [aOR, 2.5; 95% CI 1.7-3.8), follow-up care (aOR, 1.6; 95% CI 1.1-2.3), and prescription filling (aOR, 1.5; 95% CI 1.1-1.9) due to cost. Non-cost barriers for Black patients included lack of transportation aOR, 3.2; 95% CI 2.3-4.3) while Hispanic patients had higher odds of reporting delayed care due to childcare (aOR, 2.9; 95% CI 1.5-5.5) and care to an adult (aOR, 1.8; 95% CI 1.0-3.3) responsibilities. Black and Hispanic patients had higher odds of placing importance on having a provider with a similar background (aOR, 2.4; 95% CI 1.9-3.0; aOR, 3.1, 95% CI 2.4-3.9) and of never having had such a provider (aOR, 4.6; 95% CI 3.2-6.6; aOR, 3.1, 95% CI 2.4-3.9), respectively. They also had higher odds of reporting delayed care due to provider background differences (aOR, 1.9, 95% CI 1.4-2.4; aOR, 1.6, 95% CI 1.2-2.2), respectively. Additionally, Hispanic patients had higher odds of reporting not being treated with respect by their provider (aOR, 1.6; 95% CI 1.0-2.5).

conclusionsRacial and ethnic disparities significantly impact ASD patients with Hispanic and Black patients facing higher rates of cost and non-cost barriers to care. The healthcare practitioners especially those specializing in ASD play a crucial role in recognizing and addressing these disparities to improve healthcare access and outcomes across racial and ethnic groups. LEVEL OF EVIDENCE: Prognostic Level III.

Indexed as

EthnicityHealthcare DisparitiesHealth Services AccessibilityRacial GroupsSpinal CurvaturesAdultAgedCross-Sectional StudiesFemaleHumansMaleMiddle AgedSocioeconomic FactorsUnited StatesAdult spinal deformityBarriers to careEthnicityRace

Identifiers

PMID40437324

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.