Evidence map›Paper›PMID 42487499›Full record

ArticleBirth defects research2026

Racial and Ethnic Differences in Healthcare Access and Utilization Among Adults With Congenital Heart Defects in the Congenital Heart Survey to Recognize Outcomes, Needs and Well-Being (CH STRONG).

Mir M Ali, Jenil Patel, Ruiqi Cen, Elijah H Bolin, Anthony Goudie, Scott E Klewer, Matthew E Oster, Jill Glidewell, Karrie F Downing, Sherry L Farr and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Birth defects research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Mir M AliInstitute for Digital Health and Innovation, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.ORCID 0000-0002-3199-5261
Jenil PatelDepartment of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas, Texas, USA.ORCID 0000-0002-4875-7390
Ruiqi CenDepartment of Epidemiology, Fay W Boozman College of Public Health and the Arkansas Center for Birth Defects Research and Prevention, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.ORCID 0000-0002-2668-4901
Elijah H BolinDepartment of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas, USA.
Anthony GoudieArkansas Children's Research Institute, Little Rock, Arkansas, USA.
Scott E KlewerDepartment of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona, USA.
Matthew E OsterChildren's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, Georgia, USA.
Jill GlidewellNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Karrie F DowningNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID 0000-0002-3063-1781
Sherry L FarrNational Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Wendy N NembhardDepartment of Epidemiology, Fay W Boozman College of Public Health and the Arkansas Center for Birth Defects Research and Prevention, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.ORCID 0000-0002-8318-4049

Funding

CDC HHS U38O2000199Intramural CDC HHS CC999999March of Dimes Foundation
6 · The paper itself

Abstract

backgroundWe assessed healthcare access and utilization among adults with congenital heart defects (ACHD) across racial and ethnic groups using a US population-based sample.

methodsThe cross-sectional CH STRONG was conducted from 2016 to 2019 among ACHD in Arkansas, Arizona, and Atlanta. Participants completed a self-administered questionnaire on their healthcare access, utilization, health status, comorbidities, and demographics. Differences in healthcare access and utilization among non-Hispanic White (NH-White), non-Hispanic Black (NH-Black), and Hispanic ACHD were assessed, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CI) reported. Health-related quality of life (HRQOL) was also compared with standardized norms for the general population from the Patient-Reported Outcomes Measurement Information System (PROMIS). Models were adjusted for age, sex, educational attainment, marital status, study site, and CHD severity.

resultsOf 1455 respondents, 76.7% were NH-White, 15.0% were NH-Black, and 8.9% were Hispanic. Compared to NH-White, NH-Black ACHD were less likely to have health insurance (aPR = 0.94; CI: 0.88-0.99) and more likely to report a prior gap in insurance coverage (aPR = 1.88; CI: 1.44-2.46). They were also less likely to have a usual place of care (aPR = 0.82; CI: 0.75-0.89) or any healthcare visits (aPR = 0.88; CI: 0.81-0.96) but more likely to have ≥ 1 emergency room visit (aPR = 1.66; CI: 1.38-2.00) and hospitalization (aPR = 1.96; CI: 1.40-2.74) in the past year. Hispanic ACHD were more likely than NH-White to report a prior gap in insurance coverage (aPR = 1.78; CI: 1.19-2.65). CH STRONG ACHD did not differ from the general population on global mental-health and physical-health scores.

conclusionsRacial and ethnic differences in healthcare access and utilization exist among a population-based group of ACHD. Strategies for improvement in access to quality care may help reduce differences.

Indexed as

Health Services AccessibilityHeart Defects, CongenitalPatient Acceptance of Health CareAdultArizonaArkansasBlack or African AmericanCross-Sectional StudiesEthnicityFemaleGeorgiaHispanic or LatinoHumansMaleMiddle AgedQuality of Lifeadult congenital heart diseasehealthcare accesshealthcare utilizationinsurance

Identifiers

PMID42487499
PMCPMC13392593

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.