Objective: To review the literature on healthcare disparities in Parkinson’s care in the United States and to initiate a community education program targeted at an underserved PD population and primary healthcare providers in Kentucky.

Background: Parkinson’s disease (PD) is a common neurodegenerative disorder imposing a significant economic burden on the healthcare system. Although there is no definitive cure, symptomatic therapies can improve the quality of life. Previous studies have shown considerable disparities in PD care based on gender, race and socioeconomic status.

Method: A comprehensive literature search from 1996 – 2018 was performed for studies addressing healthcare disparities in PD based on gender, race, and socioeconomic status. Furthermore, a community outreach program was developed with the aim of educating patients, caregivers and primary healthcare providers in underserved areas in Kentucky on up-to-date diagnosis and treatment of PD.

Results: Significant delays in PD diagnosis and treatment along with discrepancies in the use of rehabilitation services were observed. An average seven-year delay in diagnosis of PD in the African American (AA) population was reported in one study. Furthermore, AA patients were found to be 4 times less likely to be started on treatment for PD than Caucasian patients. Rehabilitation services were least likely to be utilized by AA patients. Women with PD were reported to have fewer direct physician contact. Disparities in PD can be attributed to differences such as insurance coverage, access to medical care, cultural barriers and healthcare literacy. To address local healthcare disparities for PD patients, we partnered with a family health center in Louisville, KY, and organized educational events targeting underserved patient groups, as well as a three-part webinar on diagnosis and treatment of PD for healthcare professionals working in primary care settings.

Conclusion: Optimal management of PD requires timely diagnosis, prompt treatment, and regular follow-up to monitor both motor and non-motor symptoms. Since disparities exist on several levels, different approaches are needed to address the root cause. Better education of patients and healthcare providers in underserved areas, along with creating public awareness on PD, are important first steps towards addressing disparities and improving PD care.

References: 1. Fullard ME, Thibault DP, Todaro V, et al; Sex disparities in health and health care utilization after Parkinson diagnosis: Rethinking PD associated disability. Parkinsonism Relat Disord. 2018 Mar;48:45-50. 2. Dahodwala N, Siderowf A, Xie M, Noll E, Stern M, Mandell DS. Racial differences in the diagnosis of Parkinson’s disease. Mov Disord. 2009 Jun 15; 24(8):1200-5 3. Fullard ME, Thibault DP, Hill A, et al. Utilization of rehabilitation therapy services in Parkinson disease in the United States. Neurology. 2017;89(11):1162-1169. 4. Dahodwala N, Siderowf A, Xie M, Noll E, Stern M, Mandell DS. Racial differences in the diagnosis of Parkinson’s disease. Mov Disord. 2009 Jun 15; 24(8):1200-5. 5. Saadi A, Himmelstein DU, Woolhandler S, Mejia NI. Racial disparities in neurologic health care access and utilization in the United States. Neurology. 2017;88(24):2268-2275.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/healthcare-disparities-in-patients-with-parkinsons-disease-a-comprehensive-literature-review-and-call-to-action/