A Systematic Review of Health Disparities in Chronic Rhinosinusitis in the United States.

Abstract

Objective: Literature describing disparities in chronic rhinosinusitis (CRS) often analyzes race, gender, or socioeconomic status (SES) in isolation. Analyses encompassing a comprehensive range of disparities remain lacking. We conducted a systematic review to provide a detailed characterization of the CRS disparity landscape.

Data sources: A systematic review was conducted in Covidence adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A search of PubMed/MEDLINE, CINAHL, Scopus, etc. was performed for literature published through September 2024.

Review methods: A total of 690 publications were identified and screened by two authors independently. In total, 26 ultimately met the inclusion criteria. Studies were classified by pertaining health disparity (race, gender, SES, age, and geographic region) and reported outcomes (incidence, severity, and treatment choice).

Results: In total, 26 studies on CRS disparities were published from 2012 to 2024. 16 focused on SES, describing that lower SES was associated with reduced treatment adherence, resulting in poorer endoscopic findings and quality of life. 14 studies examined racial/ethnic disparities. Hispanic patients were more symptomatic than non-Hispanic patients, whereas black patients had fewer health visits, leading to worse outcomes. Other studies discussed the impact of gender, age, and/or geographic region (n = 9, 4, 4, respectively). Findings included higher symptom burden among female patients and higher CRS incidence in regions of air pollution. Only three studies proposed solutions to disparities.

Conclusion: Most literature on CRS disparities describes the influence of SES and race on disease presentation and progression. Other disparities related to gender, age, and geographic region were identified. Further research should uncover root causes and propose detailed solutions to advance equitable care in CRS.