Racial/Ethnic Disparities Exist Among Patients Who Undergo Anterior Cruciate Ligament Reconstruction in Socioeconomic Status, Perception of Health Status and Literacy

Abstract

Purpose

To evaluate whether socioeconomic factors, self-perception of health, health literacy, and access to health differ between racial/ethnic cohorts of patients who undergo anterior cruciate ligament reconstruction (ACLR).

Methods

This was a cross-sectional study using data from the National Institutes of Health All of Us Database. Adult patients who underwent ACLR, identified by Current Procedural Terminology code 29888, were analyzed by race/ethnicity cohorts White/Caucasian (WC), Non-White Hispanic (NWH), Black/African American (BAA), and Asian (AZN). Background demographic and socioeconomic status data from questionnaire responses regarding health status, literacy, and barriers to health care were assessed.

Results

In total, 440 patients who underwent ACLR were included in the study; 298 (68%) were WC, 79 (18%) were NWH, 49 (11%) were BAA, and 14 (3%) were AZN. Baseline demographics and socioeconomic status were significantly different, with BAA and NWH cohorts reporting lower education levels (P < .001), health care coverage (P = .04), annual income (P < .001), homeowner status P < .001), and marital status (P < .001) and a greater frequency of smoking (P < .001). Baseline health status and perceptions of self-health differed between cohorts, including average pain (P < .001), ability to perform everyday activities (P < .001), and general (P < .001), mental (P = .04), and physical health (P = .003). Health material understanding varied among cohorts (P < .05), with AZN and WC cohorts having greater positive responses to understanding health materials. BAA had greater positive response rates for an inability to afford care (P < .05).

Conclusions

Racial/ethnic disparities exist among patients who undergo ACLR, with Black/African American and Non-White Hispanics patients more often reporting inequity in socioeconomic status, perception of health status, health literacy, and access to health care.

Level of Evidence

Level III, retrospective cohort study.