Characterizing differences inoutpatient dermatologic care utilizationamong disaggregated Asian American subgroups.

Abstract

Despite having significantly higher rates of atopic dermatitis, psoriasis, and pigmentary disorders compared to White patients, studies suggest that Asian Americans are underrepresented in outpatient dermatology clinics. In this study, we utilize the National Health Interview Survey (NHIS) and prioritize disaggregated analyses to evaluate differences between the most populous Asian American subgroups (Chinese, Filipino, Indian, and "Other") in utilization of outpatient dermatologic care. We utilized multivariable logistic regression to compare outpatient dermatologic care use between each Asian American subgroup and Non-Hispanic Whites. Out of 96,559 adults, our study included 5264 self-identified Asian American and 91,295 non-Hispanic White adults. Most Asian participants were female, had health insurance, and had incomes > 2 times above the federal poverty line. We found that, compared to 21.4% for NH whites, lifetime prevalence of total body skin exam was highest among Filipino Americans (12.3%) and lowest among Indian Americans (7%). Additionally, all Asian American subgroups had a significantly lower odd than NH Whites of ever having a total body skin exam, with Indian Americans having the lowest odds. While thebenefitofTBSEs inIndian Americansis unclear,it is possible that differing cultural perceptions about dermatologic needs,barriers to care,orimmigration status may be contributing tothe observed difference. Furthermore, the Indian diaspora encapsulates a range of skin tones, risk factors, and behaviors that maydifferentiallyinfluencedermatologic disease risk,similar totrends identified among Hispanic patients (Trepanowski et al. in J Am Acad Dermatol 88:1206-1209, 2023). Additional researchutilizingthe sevennational databasesthat have been identifiedasprovidingdisaggregated Asian racial information (Kamal et al. in J Am Acad Dermatol, 2023)maybe useful to furtherilluminate avenues for intervention.