{"title":"Perceptions of health disparities among neurologists treating Black patients with epilepsy: A survey study in the United States","authors":"Ima Ebong , Pam Eads , Georgette Charles","doi":"10.1016/j.eplepsyres.2025.107637","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Many factors influence patients’ experience with epilepsy, including inequities based on socially defined race and ethnicity. We sought to better understand factors contributing to health disparities in Black people living with epilepsy (PWE), as perceived by neurologists, and the value of programs to help healthcare providers (HCPs) reduce these disparities.</div></div><div><h3>Methods</h3><div>An online, blinded, cross-sectional survey was administered to neurologists (November 8–18, 2022) whose population of PWE included ≥ 20 % of Black individuals and who had managed ≥ 10 PWE in the last 30 days. Questions assessed recognition of health disparities in PWE and the value of HCP-focused programs to address disparities. Statistical comparisons were performed by practice setting (academic vs. community).</div></div><div><h3>Results</h3><div>Of 101 neurologists, 48.5 % and 51.5 % worked in academic and community settings, respectively, 2.0 % of all neurologists were Black, and 28.3 % of neurologists’ patients were Black. Situations most commonly having a major/severe negative health impact were ‘inconsistent treatment adherence/compliance’ and ‘have significant comorbidities’ in all PWE, and ‘missed appointments’ and ‘mistrust in the healthcare system’ in Black PWE. In total, 27.7 % of neurologists (42.9 % academic vs. 13.5 % community-based; p < 0.05) completely agreed that racism is a social determinant of health (SDOH). HCP-focused programs were generally considered as somewhat/very important to improve outcomes in Black PWE.</div></div><div><h3>Conclusions</h3><div>Fewer than a third of neurologists completely agreed that racism is an SDOH, variably suggesting no perceived differences in their patient populations (leading to disagreement) or providing evidence of implicit/unconscious bias. Increasing neurologists' participation in HCP-focused programs may help counter health disparities in Black PWE, or at a minimum improve awareness that disparities exist.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107637"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epilepsy Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S092012112500138X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
Many factors influence patients’ experience with epilepsy, including inequities based on socially defined race and ethnicity. We sought to better understand factors contributing to health disparities in Black people living with epilepsy (PWE), as perceived by neurologists, and the value of programs to help healthcare providers (HCPs) reduce these disparities.
Methods
An online, blinded, cross-sectional survey was administered to neurologists (November 8–18, 2022) whose population of PWE included ≥ 20 % of Black individuals and who had managed ≥ 10 PWE in the last 30 days. Questions assessed recognition of health disparities in PWE and the value of HCP-focused programs to address disparities. Statistical comparisons were performed by practice setting (academic vs. community).
Results
Of 101 neurologists, 48.5 % and 51.5 % worked in academic and community settings, respectively, 2.0 % of all neurologists were Black, and 28.3 % of neurologists’ patients were Black. Situations most commonly having a major/severe negative health impact were ‘inconsistent treatment adherence/compliance’ and ‘have significant comorbidities’ in all PWE, and ‘missed appointments’ and ‘mistrust in the healthcare system’ in Black PWE. In total, 27.7 % of neurologists (42.9 % academic vs. 13.5 % community-based; p < 0.05) completely agreed that racism is a social determinant of health (SDOH). HCP-focused programs were generally considered as somewhat/very important to improve outcomes in Black PWE.
Conclusions
Fewer than a third of neurologists completely agreed that racism is an SDOH, variably suggesting no perceived differences in their patient populations (leading to disagreement) or providing evidence of implicit/unconscious bias. Increasing neurologists' participation in HCP-focused programs may help counter health disparities in Black PWE, or at a minimum improve awareness that disparities exist.
期刊介绍:
Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.