Low rate of dermatology outpatient visits in Asian-Americans: an initial survey study for associated patient-related factors.

Bharathi Lingala,Shufeng Li,Allison K Truong,Anne Lynn S Chang,David Kim,Ashley Wysong

doi:10.1186/1471-5945-14-13

Abstract

BackgroundAsian-Americans represent the fastest growing minority group in the United States, but are under-represented patients in outpatient dermatology clinics. At the same time, skin cancer rates in individuals of Asian descent are increasing, but skin cancer detection appears to be delayed in Asian-Americans compared to white individuals. Some health-care provider related factors for this phenomenon have been reported in the literature, but the patient-related factors are unclear.MethodsThis exploratory study to identify patient-related factors associated with dermatology visits in Asian-Americans was performed after Institutional Review Board (IRB) approval. An anonymous, online survey utilizing validated items was conducted on adults who self-identified as Asian-American in Northern California. Univariate and multivariate logistic regression for dermatology visits as indicated by responses to the question of “ever having had skin checked by a dermatologist” were performed on survey responses pertaining to demographic information, socioeconomic factors, acculturation, knowledge of melanoma warning signs and SSE belief and practice.Results89.7% of individuals who opened the online survey completed the items, with 469 surveys included in the analysis. Only 60% reported ever performing a SSE, and only 48% reported ever having a skin examination by a dermatologist. Multivariate models showed that “ever performing SSE” (p < 0.0001), marital status (p = 0.02), family history of skin cancer (p = 0.03) and generation in the United States (p = 0.02) were significant predictors of the primary outcome of “ever had skin checked by a dermatologist”.ConclusionsIdentification of patient-related factors that associate with dermatology clinic visits in Asian-Americans is important so that this potential gap in dermatologic care can be better addressed through future studies.

Highlights

Asian-Americans represent the fastest growing minority group in the United States, but are under-represented patients in outpatient dermatology clinics
This study examines factors that correlate with “ever having skin checked by a dermatologist” in a Northern California Asian-American population
An online survey study of adults in Northern California who self-identified as Asian-American was performed and included items on demographic information, socioeconomic factors, acculturation, belief in skin self-examination (SSE), having heard of melanoma warning signs, SSE practices and ever having skin checked by dermatologist

Summary

Introduction

Asian-Americans represent the fastest growing minority group in the United States, but are under-represented patients in outpatient dermatology clinics. According to the 2012 United States Census Bureau, Asian-Americans currently represent the fastest growing minority group [1]. Data from the National Ambulatory Medical Care Survey (NAMCS) in 2010 showed that Asian-American represent only 1.07% of ambulatory care visits to dermatologists even though they comprise 3% of the American population. This is potentially concerning as the overall incidence rate of melanoma appears to be rising at 2.4% per year from. Asians/Pacific Islanders in the U.S had lower 5-year survival rates than whites [2]

Objectives

Methods

Results

Conclusion