Abstract
Objective: The purpose of our study is to review the literature on healthcare disparities in PD care among African-American patients in the US.
Background: Parkinson’s disease (PD) is among the most prevalent neurodegenerative disorders and poses a high economic burden on the healthcare system. Although no cure is available, patients can have many productive years when receiving state-of-the-art treatment. Previous studies have shown considerable disparities in PD care based on racial and socioeconomic status, specifically in the African-American community.
Design/Methods: Publications from 1996–2016 were reviewed, using the following databases: PubMed, Medline, Scopus, Embase, and Ovid.
Results: We identified 15 articles meeting our criteria. Studies showed evidence of significant disparities in time of diagnosis and treatment received. One study found African-American patients four times less likely to be started on treatment for PD than Caucasians over the same follow-up period. A study performed in the VA system showed an average seven-year delay in receiving a diagnosis of PD in the African-American population. Review of a large hospital database revealed discrepancies in access to deep brain stimulation surgery, with 85.9% of patients being Caucasian and only 0.6% African-American. Disparities in PD care may result from differences in insurance status, access to medical care, cultural biases and healthcare literacy.
Conclusions: Optimal management of PD requires timely diagnosis, treatment initiation and regular follow- up to address motor and non-motor symptoms. Disparities exist on several levels for African-American patients and efforts are urgently needed to address these. Creating public awareness of racial disparities in PD care is a first step to initiate changes. We developed a local initiative in Kentucky (“UofL Moves!”) to provide PD education to underserved patients and families, spread awareness and knowledge about racial disparities to healthcare providers and provide resources for PD care for everyone.
Disclosure: Dr. Naik has nothing to disclose. Dr. LaFaver has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Teva, GLG .
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