TY - JOUR
T1 - Disparities in diagnosis, treatment and survival between Black and White Parkinson patients
AU - Xie, Tao
AU - Liao, Chuanhong
AU - Lee, Danielle
AU - Yu, Huiyan
AU - Padmanaban, Mahesh
AU - Kang, Wenjun
AU - Johnson, Julie
AU - Alshaikh, Jumana
AU - Yuen, Carlen
AU - Burns, Matthew
AU - Chiu, Brian C.H.
N1 - Funding Information:
We thank the Parkinson's Foundation in the US for awarding us the research grant (PI: TX), and the Bucksbaum Institute of Clinical Excellence and the CRI at the University of Chicago for supporting the study .
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/6
Y1 - 2021/6
N2 - Introduction: Racial disparities in diagnosis, treatment and survival in Black patients with Parkinson's disease (PD) compared to White patients have not been well studied, largely due to limited number of studies and information on Black patients in healthcare systems. Studying racial disparities and identifying underlying factors in large populations are important to understand PD and improve care. Methods: We retrospectively identified PD patients on both races from 1/1/2006 to 10/31/2017 and compared demographics, socioeconomic status (educations, incomes and insurances), comorbidities (all categories, including mood, cognition and psychosis), treatment (medications for parkinsonism and major non-motor symptoms, and frequency and locations of healthcare) and survival, and identified factors associated with medication usage and survival. Results: We retrospectively studied 2033 PD patients, of whom 725 were Black. Black patients lacked male predominance, were 4 years older at first diagnosis here, more likely to smoke and live in a low education and income community, and possessed limited insurances compared to White patients. Black patients also had more comorbidities and were more likely to receive care through emergency or inpatient service, but less likely to be on medications for parkinsonism and mood disorders. Race, age, smoking status, insurance type, frequency and locations of healthcare and comorbidities were associated with medication usage. Black race, older age, inpatient admission and malignancy were associated with increased risk of death. Conclusion: We revealed racial disparities in diagnosis, treatment and survival, and factors associated with medication usage and survival in the largest reported Black PD cohort from a single center.
AB - Introduction: Racial disparities in diagnosis, treatment and survival in Black patients with Parkinson's disease (PD) compared to White patients have not been well studied, largely due to limited number of studies and information on Black patients in healthcare systems. Studying racial disparities and identifying underlying factors in large populations are important to understand PD and improve care. Methods: We retrospectively identified PD patients on both races from 1/1/2006 to 10/31/2017 and compared demographics, socioeconomic status (educations, incomes and insurances), comorbidities (all categories, including mood, cognition and psychosis), treatment (medications for parkinsonism and major non-motor symptoms, and frequency and locations of healthcare) and survival, and identified factors associated with medication usage and survival. Results: We retrospectively studied 2033 PD patients, of whom 725 were Black. Black patients lacked male predominance, were 4 years older at first diagnosis here, more likely to smoke and live in a low education and income community, and possessed limited insurances compared to White patients. Black patients also had more comorbidities and were more likely to receive care through emergency or inpatient service, but less likely to be on medications for parkinsonism and mood disorders. Race, age, smoking status, insurance type, frequency and locations of healthcare and comorbidities were associated with medication usage. Black race, older age, inpatient admission and malignancy were associated with increased risk of death. Conclusion: We revealed racial disparities in diagnosis, treatment and survival, and factors associated with medication usage and survival in the largest reported Black PD cohort from a single center.
KW - Black
KW - Disparity
KW - Medications
KW - Parkinson's disease
KW - Survival
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U2 - 10.1016/j.parkreldis.2021.04.013
DO - 10.1016/j.parkreldis.2021.04.013
M3 - Article
C2 - 33905958
AN - SCOPUS:85107120574
SN - 1353-8020
VL - 87
SP - 7
EP - 12
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
ER -