Racial Disparities in Healthcare Resource Utilization among Patients with Hidradenitis Suppurativa: An All of Us Database Analysis.

Abstract

Introduction: Hidradenitis suppurativa (HS) disproportionately affects historically underrepresented populations, with social determinants of health (SDoH) contributing to disparities in access to care, specialty services, and medication access. This study aimed to evaluate healthcare utilization in HS, stratified by race, to better understand the role of SDoH.

Methods: A cross-sectional analysis using the All of Us database was conducted using variables including surgical procedures, healthcare utilization, biologic use, and pertinent comorbidities (diabetes, obesity, smoking, sepsis). Survey data assessed socioeconomic factors and healthcare access. Chi-square tests were used (p < 0.005); analyses were performed in RStudio 4.1.2.

Results: Among 2,265 patients with HS (40.26% African American, 77.48% female), African American patients had higher rates of emergency department visits, diabetes, complex surgeries, and inability to afford medications (all p < 0.01). White patients had more outpatient visits and delays in care due to anxiety (p < 0.0005 and p < 0.026, respectively).

Conclusions: Racial disparities in HS healthcare utilization reflect the impact of SDoH, with African American patients experiencing greater disease burden. Early identification of high-risk patients and targeted interventions are essential to promote equitable care.