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Purpose <p>To understand the impact of socioeconomic disparity on patient-reported outcomes, health literacy, and access to care in primary malignant brain tumors (PMBT).</p> Methods <p>We performed a retrospective analysis of adults with PMBT using the NIH All of Us Program database. An aggregate of income, insurance, education, employment, and housing called Individual Socioeconomic Deprivation Index (iSDI) was measured for each patient and a multivariate regression was conducted to measure its effect on self-reported symptom burden, health status, health literacy, and barriers to healthcare access.</p> Results <p>873 patients with primary malignant brain tumors completed post-diagnosis surveys. Across these patients, higher iSDI (more deprivation) was associated with consistently worse patient-reported outcomes. Higher iSDI was strongly associated with worse fatigue, more pain, and greater emotional distress including anxiety and depression and lower functional independence (adjusted <i>p</i> &lt; 0.001). Higher iSDI was also significantly linked to poorer general, mental, and physical health, as well as lower overall quality of life (all adjusted <i>p</i> &lt; 0.001). Greater deprivation also increased the odds of worse patient understanding of presented written material, increased feeling of needing assistance with filling out health material, and lower confidence in filling out medical forms (all adjusted <i>p</i> &lt; 0.001). In contrast, iSDI was not associated with cost-related barriers to care, including delaying prescription fills, skipping medication to save money, heightened worry about paying for medical care, or with difficulty affording follow-up care, a healthcare provider, or a specialist (all adjusted <i>p</i> ≥ 0.05).</p> Conclusions <p>Patients socioeconomic background has a significant influence on patient-reported outcomes and health literacy in individuals with PMBT. These findings extend prior evidence linking socioeconomic background to treatment access and survival, underscoring the need for targeted interventions that address financial toxicity, and supportive care in addition to equitable access to medical information.</p>

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Socioeconomic disparities in patient-reported outcomes, health literacy, and access to care among patients with primary brain tumors: findings from the All of Us Research Program

  • 期刊论文

  • 发表日期：

    2025年12月15日

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  • Shailen G. Sampath,
  • Alex Hernandez Manriquez,
  • Hannah Haile,
  • Miles Botkiss,
  • Chiemela Izima,
  • Arjun R. Adapa,
  • Nathan A. Shlobin,
  • Michael G. Argenziano,
  • Cheng-Shiun Leu,
  • Brian J. A. Gill

摘要

Purpose

To understand the impact of socioeconomic disparity on patient-reported outcomes, health literacy, and access to care in primary malignant brain tumors (PMBT).

Methods

We performed a retrospective analysis of adults with PMBT using the NIH All of Us Program database. An aggregate of income, insurance, education, employment, and housing called Individual Socioeconomic Deprivation Index (iSDI) was measured for each patient and a multivariate regression was conducted to measure its effect on self-reported symptom burden, health status, health literacy, and barriers to healthcare access.

Results

873 patients with primary malignant brain tumors completed post-diagnosis surveys. Across these patients, higher iSDI (more deprivation) was associated with consistently worse patient-reported outcomes. Higher iSDI was strongly associated with worse fatigue, more pain, and greater emotional distress including anxiety and depression and lower functional independence (adjusted p < 0.001). Higher iSDI was also significantly linked to poorer general, mental, and physical health, as well as lower overall quality of life (all adjusted p < 0.001). Greater deprivation also increased the odds of worse patient understanding of presented written material, increased feeling of needing assistance with filling out health material, and lower confidence in filling out medical forms (all adjusted p < 0.001). In contrast, iSDI was not associated with cost-related barriers to care, including delaying prescription fills, skipping medication to save money, heightened worry about paying for medical care, or with difficulty affording follow-up care, a healthcare provider, or a specialist (all adjusted p ≥ 0.05).

Conclusions

Patients socioeconomic background has a significant influence on patient-reported outcomes and health literacy in individuals with PMBT. These findings extend prior evidence linking socioeconomic background to treatment access and survival, underscoring the need for targeted interventions that address financial toxicity, and supportive care in addition to equitable access to medical information.