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Kidney Week

Abstract: SA-PO061

Area Deprivation Index and Spanish Language Are Barriers to Equitable Nephrology Care in a Hispanic Pediatric Subspecialty Cohort

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Becerril Romero, Carlos Cesar, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Kula, Alexander J., Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Verghese, Priya S., Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
  • Matossian, Debora, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, United States
Background

Hispanics are the largest population of Chicago youth and they have an increased risk and rate of chronic kidney disease progression. Addressing healthcare disparities in Hispanic patients is important to improve health outcomes. This study aims to understand the impact of language and socioeconomic disadvantage on access to care in Hispanic patients seen in pediatric nephrology clinics.

Methods

All patients that identified as Hispanic seen in Lurie Children’s Hospital nephrology clinic between January and June 2021 received the validated tool “Barriers to Care Questionnaire” to assess healthcare access. Parents or patients older than 18 completed the survey in their preferred language. A score of 100 equates no barriers to care, and a score < 75 equates a failed score due to high barriers. We also collected sociodemographic data and the Area Deprivation Index (ADI), a metric of socioeconomic disadvantage that incorporates 17 socioeconomic measures. The national ADI score ranges from 1 (most advantaged) to 100 (most disadvantaged). We created linear regression models to describe the association between barriers and ADI scores and tested for interactions based on language.

Results

In 109 surveys (49% Spanish, 51% English), we identified high skills and pragmatic barriers to care, with mean (+/-standard deviation) scores of 74 (+/-26) and 75 (+/-21), respectively. The mean ADI score was 55 (+/-20). Spanish-speaking families had higher skills barriers (p<0.001); no difference in pragmatic barriers (p=0.40) and mean ADI score (p=0.38). A higher ADI score correlated with higher total barriers (p=0.006) and significant interaction effect by language (p=0.04).

Conclusion

Hispanic youth in Chicago face significant barriers to accessing nephrology care. Spanish-speaking patients with higher socioeconomic disadvantages struggle to navigate the healthcare system. Findings indicate the need for a diverse and multicultural team to support Spanish-speaking families. Prospective studies are necessary to advocate for programs and policy changes to address these barriers and reduce racial and ethnic disparities in pediatric nephrology care.