Social Determinants Research Articles

The rise of congenital syphilis in Canada: threats and opportunities

IntroductionIn Canada, rates of congenital syphilis have been increasing rapidly in recent years, following a surge in infectious syphilis. These trends call for a closer look at missed opportunities for testing, diagnosis, treatment, and follow-up of pregnant individuals. The epidemiological situation is especially serious given that effective treatment is available for syphilis during pregnancy and that congenital syphilis is a preventable outcome that engenders adverse birth outcomes such as miscarriage, stillbirth, and neonatal death as well as potentially lifelong ocular, neurological, hepatosplenic, and musculoskeletal sequelae. The objective of this study is to examine the factors associated with congenital syphilis trends and to highlight promising initiatives and programs across the country committed to addressing these trends.MethodsA literature review with a focus on Canadian studies was conducted to identify factors that may be driving the continued increase in early congenital syphilis rates over the past decade. An environmental scan of initiatives and programs providing syphilis care and support was also conducted.ResultsKey factors identified in association with congenital syphilis outcomes included a lack of timely and repeated prenatal syphilis screening, inadequate prenatal treatment and follow-up of syphilis infection, barriers to accessing prenatal care caused by multiple intersecting social determinants of health as well as by certain structural determinants of health, and substance use. A number of initiatives to improve syphilis care within the health care system and several community-based programs filling in some of the gaps in syphilis care and support are making important advances in addressing the epidemiological situation with syphilis.DiscussionMuch work is underway at various levels of government and local community to address the situation. Key recommendations for maximizing impact in curbing infectious and congenital syphilis rates include the following: planning an integrated strategy for addressing sexually transmitted and blood-borne infections as a whole; adopting a more holistic approach to improving health and wellbeing; developing targeted interventions for addressing structural and social barriers to health equity; and taking a collaborative approach to response by involving multilevel stakeholders, such as key populations, community groups, health care providers, and public health authorities.

Social Determinants of Health in Machine-Learning Algorithms.

Social Determinants of Health in Machine-Learning Algorithms.

Quality of Life and Social Health in Patients After Pancreatic Surgery.

Clinicians lack robust data on quality of life and social functioning after pancreatectomy limiting their ability guide patient decision-making aligned with patients' goals of care. In this cross-sectional survey study, we administered the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30); pancreas-specific QLQ-PAN26; Patient-Reported Outcomes Measurement Information System (PROMIS™) Ability to Participate in Social Roles; and PROMIS™ Activities and social Isolation scales to all elective pancreatectomies (2021-2023). Results were compared to both normative data and between groups to determine factors predicting better QOL with a >10-12-point change considered clinically significant. 143 patients were included. 71 (49.6%) completed the distributed surveys. The average age of responders was 59.9±16.1 years with 56.3% men. Pancreaticoduodenectomy (54.9%) was performed for malignancy in 67.6% of cases. Compared to normative population controls, post-pancreatectomy patients reported lower role functioning scores (67.2±28.7 vs 81.7±28.2, 14.5 score difference) but less social isolation (40.6±5.7 vs 50.0±10.0, 9.4 score difference). Compared to patients with benign disease, those with malignancy reported clinically significant worse social functioning; more fatigue, pain, constipation, change in taste, weight loss, weakness, and altered bowel habits; worse body image; and increased worries about the future. Despite more symptoms they were more satisfied with the healthcare they received (all >10-point score difference). QOL and social health are impacted by pancreatic resection and outcomes differ whether surgery was performed for benign or malignant disease. These issues are largely unaddressed and are potential targets for intervention to improve QOL.

Network of job demands-resources and depressive symptoms in critical care nurses: a nationwide cross-sectional study

BackgroundCritical care nurses are vulnerable to depression, which not only lead to poor well-being and increased turnover intention, but also affect their working performances and organizational productivity as well. Work related factors are important drivers of depressive symptoms. However, the non-liner and multi-directional relationships between job demands-resources and depressive symptoms in critical care nurses has not been adequately analyzed. Understanding these relationships would be helpful for reducing depression, increasing nurses’ well-being and retain healthcare forces.MethodsThis was a cross-sectional study using baseline data from the Nurses’ mental health study (NMHS), a prospective cohort study on nurses from 67 tertiary hospitals in 31 province-level administrative regions in China. Only clinical nurses working in the ICU were included (n = 13,745). Data were collected using online questionnaires, and analyzed using network analysis and structural equation model. Job demands (average working hours per week, average number of night shifts per month, paperwork burden and work-life balance), job resources (supervisor support, co-worker support, leader justice, organizational climate satisfaction, work meaning, and career prospect), personal resource (resilience) and depressive symptoms were main variables in the networks, while demographic data and social health (social-emotional support and loneliness) were covariates.ResultsThe prevalence of severe, moderately severe, moderate, mild, and none or minimum depressive symptoms in critical care nurses of this study were 1.21, 3.42, 9.76, 42.88, and 42.07% respectively. In the final network, 132 of 210 possible edges (62.8%) were not zero. “Fatigue” had the highest expected influence, followed by “Motor”, and “Appetite”. Meanwhile, in terms of job demands-resources and personal resources, the node with the highest expected influence was “Supervisor support”, followed by “Work meaning” and “Co-worker support”. Three bridge variables were identified: “Resilience-adaptation”, “Average working hours per week”, and “Co-worker support”. The final structural equation model basically supported the results of network analysis with an acceptable model-fit (GFI = 0.918, AGFI = 0.896, PCFI = 0.789, PNFI = 0.788, NFI = 0.909, IFI = 0.911, CFI = 0.911, SRMR = 0.040, and RMSEA = 0.064).ConclusionsThere was a rather strong interconnectedness between depressive symptoms and job demands-resources. Fatigue, motor, and appetite were core depressive symptoms of critical care nurses. Close attention to those symptoms could help recognize depression in critical care nurses. Supervisor support, work meaning, and co-worker support played vital roles as job resources in reducing depression, while negative impact of long average working hours per week were more contagious. Resilience, as personal resources, could help mediate the associations between job demands-resources and depression. In clinical practice, it’s recommended for nursing managers to (1) encourage critical care nurses to find their “meaning in work”, (2) implement resilience enhancing programs for nurse, (3) build and maintain meaningful relationships with nurses and support them in daily work, and (4) create a harmonious and dedicated working environment where co-workers are willing to help and support each other. Improvements in those modifiable aspects could help reduce risk and prevent exacerbations of depressive symptoms in critical care nurses.

Editorial Comment on the Fourth Annual I-MESH Symposium: Communicating Complexity in Mental and Social Health.

Editorial Comment on the Fourth Annual I-MESH Symposium: Communicating Complexity in Mental and Social Health.

Hubungan Movement Behavior dengan Health Related Quality of Life pada Siswa/I Smp Tarakanita Citra Raya selama Pandemi Tahun 2021

Movement behavior is a combination of motion behavior that includes physical activity, sleep duration, and sedentary behavior. However, during the COVID-19 pandemic, there were several changes in human movement behavior within 24 hours due to the implementation of policies to break the chain of transmission. The impact caused by the implementation of social distancing causes limited human movement that affect the health-related quality of life for each individual, especially on indicators of children's physical, mental and social health. This study aims to see the relationship between movement behavior and health related quality of life in students of SMP Tarakanita Citra Raya during the 2021 pandemic using an analytical method with a cross sectional design. This research was conducted at SMP Tarakanita Citra Raya with 239 respondents consist of 88 male students and 151 female students. Data were collected using the GPAQ questionnaire, sleep duration, and KIDSCREEN-27 which were filled out online in December 2021. The results of this research indicate the characteristics of movement behavior that 74.06% of students do physical activity less than 1680 MET-minutes/week, 65.7% of students have a sleep duration of 6-8 hours per day, 29.29% of students perform sedentary behavior 3-4 hours, 47.28% of students do not meet the recommendation of movement behavior, and 84.94% of students have a good HRQoL. Statistical tests based on the Pearson correlation showed that there was a very weak relationship between physical activity and health related quality of life with a correlation coefficient of 0.177 with p value of 0.006 and the correlation between sleep duration and health related quality of life with a correlation coefficient of 0.190 and a p value of 0.003.

Social and environmental determinants of health inequities in childhood asthma.

Social and environmental determinants of health inequities in childhood asthma.

The pregnant moms' empowerment program - Mexico enhances mental health for women exposed to intimate partner violence: a pilot randomized controlled trial.

Given the lack of available and effective interventions to address the detrimental consequences of perinatal exposure to intimate partner violence (IPV) on maternal mental health, and reported very low access to IPV-related mental health services in Mexico, we examined the feasibility and efficacy of a culturally adapted, virtual, brief group psychosocial intervention designed to improve maternal mental and physical health and reduce IPV revictimization for pregnant women exposed to IPV. In this pilot randomized controlled trial, we evaluated maternal outcomes after participation in the Pregnant Moms' Empowerment Program (PMEP) in Mexico. Women were recruited from social service agencies and health centers in the community, as well as social media advertisements that targeted pregnant women living in Mexico. Women were randomized to receive the intervention (n = 43) or a control condition (i.e., referrals to local services; n = 47). Women completed questionnaires at baseline, post-intervention, and 3-months postpartum that assessed their exposure to IPV, depression, posttraumatic stress symptoms (PTSS), physical health symptoms, and resilience, as these were our primary outcomes of interest. Women in the intervention condition participated in ten, 60-minute virtual group sessions. Multilevel models were used to evaluate effects of treatment over time. On average, women in the intervention condition participated in six treatment sessions. Compared to the control group, intervention participants reported significantlyfewer symptoms of depression at both the post-intervention and 3-month postpartum assessments (d = 0.64, d = 0.59, respectively) and fewer physical health symptoms at the post-intervention assessment (d = 0.77). Trend-level improvements in PTSS scores for post-intervention (d = 0.56) and 3-months postpartum (d = 0.56), as well as physical health at 3-months postpartum (d = 0.59), were also observed. There were no group differences in exposure to IPV over time. The current study adds to the evidence base for the PMEP intervention while also expanding it to a new cultural context by suggesting promise of its clinical utility in targeting Mexican women's perinatal depression, PTSS, and physical health symptoms.

Operationalising routinely collected patient data in research to further the pursuit of social justice and health equity: a team-based scoping review

BackgroundVast volumes of routinely collected data (RCD) about patients are collated by health professionals. Leveraging this data – a form of real-world data - can be valuable for quality improvement and contributing to the evidence-base to inform practice. Examining routine data may be especially useful for examining issues related to social justice such as health inequities. However, little is known about the extent to which RCD is utilised in health fields and published for wider dissemination.ObjectivesThe objective of this scoping review is to document the peer-reviewed published research in allied health fields which utilise RCD and evaluate the extent to which these studies have addressed issues pertaining to social justice.MethodsAn enhanced version of the Arksey and O’Malley’s framework, put forth by Westphalm et al. guided the scoping review. A comprehensive literature search of three databases identified 1584 articles. Application of inclusion and exclusion criteria was piloted on 5% of the papers by three researchers. All titles and abstracts were screened independently by 2 team members, as were full texts. A data charting framework, developed to address the research questions, was piloted by three researchers with data extraction being completed by the lead researcher. A sample of papers were independently charted by a second researcher for reliability checking.ResultsOne hundred and ninety papers were included in the review. The literature was diverse in terms of the professions that were represented: physiotherapy (33.7%) and psychology/mental health professions (15.8%) predominated. Many studies were first authored by clinicians (44.2%), often with clinical-academic teams. Some (33.25%) directly referenced the use of their studies to examine translation of research to practice. Few studies (14.2%) specifically tackled issues pertaining to social justice, though many collected variables that could have been utilised for this purpose.ConclusionStudies operationalising RCD can meaningfully address research to practice gaps and provide new evidence about issues related to social justice. However, RCD is underutilised for these purposes. Given that vast volumes of relevant data are routinely collected, more needs to be done to leverage it, which would be supported by greater acknowledgement of the value of RCD studies.

Exploring the Psychosocial Domain of the Social Determinants of Learning™ Framework: Predictors of Perceived Stress and Resilience in Prenursing Students.

The Social Determinants of Learning™ framework can be used to conceptualize the influence of psychosocial health among students applying to nursing programs. Little is known about variables that may influence psychosocial health in these students. To describe demographic and mental health variables that predict perceived stress and resilience levels in accelerated online prenursing students. A cross-sectional, survey-based, observational design was utilized. Participants were mostly female and from diverse backgrounds. Lower levels of perceived stress were predicted by lower levels of anxiety and higher levels of resilience and self-compassion. Higher levels of resilience were predicted by male gender, higher perceptions of current ability to manage stress, and higher levels of self-compassion. Incorporating knowledge and skills to support the growth of self-compassion in prerequisite courses taken just prior to nursing program entry may help students to reduce perceived stress and support resilience.

The Role of Race/Ethnicity on the Association between Neighborhood Deprivation and Breast Cancer Outcomes among Kentucky Breast Cancer Patients years 2010-2022.

Kentucky is within the top five leading states for breast mortality nationwide. This study investigates the association between neighborhood socioeconomic disadvantage and breast cancer outcomes, including surgical treatment, radiation therapy, chemotherapy, and survival, and how associations vary by race and ethnicity in Kentucky. We conducted a retrospective cohort analysis using data from the Kentucky Cancer Registry (KCR) for breast cancer patients diagnosed between 2010 and 2017, with follow-up through December 31, 2022. We linked KCR data with census tract data to examine the relationship of Area Deprivation Index (ADI) on breast cancer outcomes. Logistic regression and Cox Proportional Hazards models analyzed binary outcomes and time-to-event data, respectively. Women in the most disadvantaged (ADI 4th quartile) neighborhoods were more likely to be diagnosed at later stages (OR: 1.26, 95% CI: 1.12-1.41) and 34% more likely to die from breast cancer (HR: 1.34, 95% CI: 1.14-1.57) after adjusting for age, race, tobacco use, tobacco pack years, marital status, insurance status, family history, stage at diagnosis, breast cancer subtype, and residence in Appalachia when compared to women living in the least disadvantaged neighborhoods (ADI 1st quartile). Women in disadvantaged neighborhoods had significantly higher odds of late-stage diagnosis and breast cancer death, regardless of race, indicating that neighborhood factors contribute to breast cancer disparities. Socioeconomic and neighborhood factors may contribute to breast cancer outcomes, suggesting the necessity for targeted interventions. Future research should explore the effectiveness of such interventions and investigate additional social determinants contributing to disparities.

Social determinants of health and health outcomes in older cancer survivors.

Today, two-thirds of all cancer survivors are at least 65years old. Older cancer survivors have complex care needs, and addressing their social determinants of health (SDoH) is critical for improving and managing survivorship outcomes for this uniquely vulnerable population, yet research specifically examining these associations remains limited and emergent. To this end, we describe the emergent body of evidence on the associations between SDoH domains and older cancer survivors' outcomes. Despite the limited investigations of SDoH on the health outcomes of older cancer survivors, there were measures representing all domains of SDoH - health care access and quality, education access and quality, neighborhood and built environment, social and community context, and economic stability. We reviewed another determinant, Digital Environment and Engagement, as they are highly relevant to older cancer survivors' care. Studies primarily investigated outcomes such as the use of or delays in treatment and variables related to care coordination. Generally, poorer access to resources such as income, social networks, and quality health care facilities predicted poorer health outcomes. We reviewed studies that revealed that SDoH significantly impacts older cancer survivors' health outcomes. Our description informs future interventions and policies to improve their care.

Neighborhood Socioeconomic Status and Breastfeeding Initiation and Duration Among Primiparous Black Women.

Background: Social determinants of health account for racial inequities in breastfeeding rates in the United States. There is a gap in the role of neighborhood socioeconomic status (NSES) as it relates to breastfeeding disparities. Methods: Using longitudinal data from the Black Women's Health Study, we assessed associations of NSES with breastfeeding initiation and duration in a cohort of primiparous U.S. Black women. We also explored associations within strata of important economic indicators, including education, occupation, and marital status. Results: Breastfeeding initiation (n = 2,705) increased with NSES quartile, from 75.2% in the lowest quartile to 88.3% in the highest quartile (p < 0.0001). Compared with women living in the highest NSES quartile, those in the lowest quartile had a 41% (odds ratio: 0.59 [95% confidence interval: 0.43, 0.81]) decreased odds of initiating breastfeeding. For breastfeeding duration (n = 2,172), women residing in NSES quartiles 1-3 were significantly less likely (p < 0.0001) to breastfeed (44.4%) for 6+ months compared with those living in the highest quartile (62.8%). Adjusted relative risks for those in quartiles 1-3 compared with 4 (highest) were 0.63 (0.45, 0.87), 0.50 (0.37, 0.68), and 0.64 (0.47, 0.86), respectively (p = 0.0001). There was no statistically significant evidence of effect modification by education, occupation, marital status, and region (Pinteraction = >0.05). Conclusion: Living in a lower NSES environment was associated with reduced breastfeeding initiation and duration compared with a higher NSES environment. Research is needed to understand the mechanisms by which neighborhood-level factors influence breastfeeding initiation and duration for Black women in the United States.

Social Determinants of Health in Patients Undergoing Open Reduction and Internal Fixation for Distal Radius Fractures

Social Determinants of Health in Patients Undergoing Open Reduction and Internal Fixation for Distal Radius Fractures

The association between county-level social determinants of health and cardio-kidney-metabolic disease attributed all-cause mortality in the US: A cross sectional analysis.

The American Heart Association recently defined cardio-kidney-metabolic (CKM) syndrome as the intersection between metabolic, renal, and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality in the US is essential for developing targeted public interventions. We analyzed state-level and county-level CKM-associated all-cause mortality data (2010-2019) from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER). Median and interquartile (IQR) age-adjusted mortality rates (aaMR) per 100,000 were reported and linked with a multi-component metric for social deprivation: the Social Deprivation Index (SDI: range 0 - 100) grouped as: I: 0 - 25, II: 26 - 50, III: 51 - 75, and IV: 75 - 100. We fit pairwise comparisons between SDI groups and evaluated aaMR stratified by sex, race, and location. In 3101 counties, pooled aaMR was 505 (441-579). Oklahoma (643) and Massachusetts (364) had the highest and lowest values. aaMR increased across SDI groups [I: 454(404, 505), IV: 572(IQR: 495.9, 654.7); p < 0.001]. Men had higher rates [602 (526, 687)] than women [427 (368, 491)]. Metropolitan [476 (419, 542)] had lower rates than non-metropolitan counties [521 (454, 596)]. Non-Hispanic Black [637 (545, 731)] had higher rates than non-Hispanic White residents [497 (437, 570]. CKM associated aaMR remained reasonably constant between 2010 and 2019 (Mann Kendall test for trend p-value = 0.99). In the US, CKM mortality disproportionately affects more socially deprived counties. Inability to reduce CKM mortality rates over the study period highlights the need for targeted policy interventions to curb the ongoing high burden.

The Role of Sex and Gender in Acute Kidney Injury - Consensus Statements from the 33rd Acute Disease Quality Initiative.

Sex differences exist in acute kidney injury (AKI), and the role that sex and gender play along the AKI care continuum remains unclear. The 33rd Acute Disease Quality Initiative meeting evaluated available data on the role of sex and gender in AKI and identified knowledge gaps. Data from experimental models, pathophysiology, epidemiology, clinical care, gender, social determinants of health, education, and advocacy were reviewed. Recommendations include incorporating sex and gender into research along the bench-to-bedside spectrum, analyzing sex-stratified results, evaluating the effects of sex chromosomes, hormones, and gender on outcomes, considering fluctuations of hormone levels, studying the impact gender may have on access to care, and developing educational tools to inform patients, providers, and stakeholders. This meeting report summarizes what is known about sex and gender along the AKI care continuum and proposes an agenda for translational discovery to elucidate the role of sex and gender in AKI across the lifespan.

Physical and social health needs of postoperative bariatric surgery patients: a focus group

PurposeThis qualitative study explored the health needs of patients after undergoing bariatric surgery. The study specifically aimed to describe the unique physical, emotional, and social challenges patients face following surgery in order to inform the development of future obesity treatment programs.MethodsA 90-min focus group was conducted using a semi-structured interview guide. Bariatric surgery patients were enrolled using purposive sampling. The mean number of months since surgery was 20.2 (SD 10.8). The mean age of participants was 53.3 (SD 9.8) years. The focus group was both audio and video recorded, transcribed, and analyzed using topic and analytical coding.ResultsThree main themes emerged revealing postoperative needs for (1) assistance with physical changes and reduced barriers to exercise, (2) reinforcement for healthy eating behaviors, and (3) emotional support from peers, family, and community.ConclusionsFindings suggest that rehabilitation following bariatric surgery is complex in nature and patients may benefit from both pre- and post-surgery programs that address their unique needs. Weight maintenance and sustaining healthy behavior change post-surgery requires ongoing personal and professional assistance. Interventions should emphasize healthy eating practices, include practical exercise suggestions, and offer social and emotional support.

The association between neighbourhood socioeconomic status and parental mental health in the first years after birth - Cross-sectional results from the SKKIPPI project.

The urban environment can influence mental health. However, research on neighbourhood influences on mental health of parents with young children is sparse. This study aimed to analyse the association between neighbourhood socioeconomic status (SES) and mental health outcomes in urban parents in the first years after birth. We included 4707 parents of young children who participated in the SKKIPPI cohort study in Berlin. Data on mental health outcomes (symptoms of depression, anxiety, or both, measured via PHQ- 4) and individual risk factors stemmed from an online questionnaire and were matched with neighbourhood level data from the Berlin Senate Department for Urban Development and Housing. Neighbourhood status (exposure) was categorized in 4 SES categories: high, medium, low, and very low. We use propensity scores to estimate the probability to live in each neighbourhood category to reduce the risk of bias due to neighbourhood self-selection. Binominal generalised linear mixed models with propensity score adjustment were used to estimate the association between neighbourhood SES and symptoms of depression, anxiety, or both. Overall, 9.3% of parents showed depressive, 10.3% anxiety, and 5.3% both symptoms. The occurrence of mental health problems was lowest in neighbourhoods with high SES and highest in neighbourhoods with low/very low SES. The association between neighbourhood SES and mental health outcomes seen in unadjusted regression models disappeared when models were adjusted for individual risk factors/neighbourhood self-selection using propensity scores. We found no association between neighbourhood SES and mental health outcomes in parents in the first years after birth after adjusting for neighbourhood selection. Nevertheless, the unadjusted findings suggest that the occurrence of individual risk factors and mental health problems was highest in neighbourhoods with low/very low SES, which should be focus for social and preventive health measures.

Real-World Rollout of Injectable Antiretrovirals for HIV Prevention and Treatment: Correlates of Early Adoption

Abstract Background Data is limited on implementation of long-acting injectable (LAI) HIV treatment (ART) and pre-exposure prophylaxis (PrEP). We characterized “early adopters” of LAI ART and PrEP in terms of social determinants of health, using a health equity lens. Methods A retrospective cohort included patients prescribed ART or PrEP through a large urban health system (January 2021-September 2023) in the Northeastern US. We used EHR data for PrEP and ART to examine group differences between those on LAI or oral medications for each, using ANOVA, chi-square tests or Fisher’s exact tests. Bivariate logistic regression modeled associations between LAI ART or LAI PrEP and social determinants of health. Results In the PrEP group, 238 patients were prescribed LAI (n=63) or oral (n=193) PrEP. Most PrEP patients were men (80.7%), non-Hispanic (79.5%), white (60.7%) and had public insurance (83.1%). Compared to patients on oral PrEP, those on LAI less often experienced food insecurity, financial strain, depression, anxiety or substance use disorders. In bivariate models, LAI PrEP inversely correlated with female sex, current smoking, depression, anxiety, and substance use disorders. In the treatment group, 1194 patients were prescribed LAI (n=76) or oral (n=1118) ART, with median age 57.0; 63.6% were from minoritized groups. Only age was significantly associated with LAI ART (OR=0.97,95% CI=0.961-0.993, p=0.005). Conclusion In this large retrospective cohort of patients on LAI PrEP and ART, patients receiving LAI less often experienced social barriers. Public health interventions are needed to overcome health inequities tied to access of LAI for HIV prevention and treatment.

Barriers to Healthcare Access and Utilization Among Racial and Ethnic Minorities with Noninfectious Uveitis.

To investigate barriers to healthcare access and utilization among patients with noninfectious uveitis (NIU) across different racial and ethnic groups. Retrospective cross-sectional study. Participants diagnosed with chronic NIU in the nationwide All of Us Research Program. We analyzed healthcare access and utilization (HCA&U) and social determinants of health (SDoH) surveys. Racial and ethnic groups were defined as non-Hispanic White, non-Hispanic Black, Hispanic, and 'Other'. Multivariable logistic regression models adjusted for age, sex, education, insurance type, and income were used to assess disparities. Financial and non-financial disparities in healthcare access among racial and ethnic groups. Of 2,452 NIU patients, 810 (33%) responded to the HCA&U survey and 607 (24.7%) to the SDoH survey. Non-Hispanic Black participants reported significantly more experiences of being treated with less courtesy (adjusted odds ratio 2.6, 95% confidence interval [1.4- 5], p=0.003) and respect (2.6 [1.4- 4.8], p=0.003), as well as receiving poorer services (3.6 [1.9- 6.9], p<0.001) compared to Non-Hispanic White participants. Individuals categorized as 'Other' minorities were more likely to delay seeking medical care due to out-of-pocket costs (3.4 [1.6- 7.1], p=0.001) and concerns over medical bills (2 [1.05- 3.8], p=0.04). Additionally, they experienced significant delays in care due to living in rural areas with limited access to healthcare providers (7.1 [1.4-35.6], p=0.02). Racial and ethnic minorities with NIU face significant barriers to healthcare utilization and quality, underscoring the need for targeted interventions to address disparities and improve health equity in uveitis management.