444 Racial/Ethnic Disparities in Perception of Health Literacy and Barriers to Care Among a Large Diverse Cohort of Cervical Stenosis Patients

INTRODUCTION: Disparities in time to diagnosis and surgical outcomes for cervical stenosis patients have been previously described. However, there has been limited investigation into self-reported barriers to care. METHODS: This cross-sectional study used ICD-9 and ICD-10 codes to identify cervical stenosis patients recorded in the NIH All of Us Research Program between 2017 and 2022. Demographic information was collected, and self-reported measures of health status, health literacy, and perceived barriers to care were compared among self-identified White (W), Black (B), and Non-White Hispanic (NWH) patients. Data excluding skipped questions were compared with chi square and fisher exact tests. RESULTS: Of 10,871 patients identified, 2077 (21%) were B, 1054 (11%) were NWH, and 6836 (69%) were W. W patients were more likely to report college education (p < .001), income >$50k per year (p < .001), and non-disabled employment status (p < .001). B and NWH patients reported higher levels of 7-10 pain (p < .001), “severe” 7-day fatigue (p < .001), and poor general health (p < .001). Differences in health literacy were noted, with B and NWH patients reporting greater rates of “always” having difficulties understanding (p < .001) and needing assistance with (p < .001) medical forms. Several barriers to care were highlighted, with significantly more B and NWH patients reporting delaying care due to unaffordable copays (p < .001), transportation difficulties (p < .001), and having providers of a different background then them (p < .001). B and NWH patients were more likely to describe having providers of a similar background as “very important” (p < .001). CONCLUSIONS: This study identified disparities in perception of health status, health literacy, and access to care among patients with cervical stenosis. These data highlight diverse patient perspectives on barriers to care which may warrant future study.