1.47 Demographic Data Disaggregation as a Means of Better Assessing Access to Mental Health Care for Pediatric MENA Patients

ObjectivesPatients of Middle Eastern and Northern African (MENA) background are inappropriately categorized as White non-Hispanic (WnH) on census data. The lack of the MENA identifier is a barrier to conducting population health studies on MENA patients. This precludes MENA communities from essential federal and local funding opportunities, and tailored public health interventions. In this study, we use age at diagnosis of ASD as a proxy to assess disparities in access to care at a tertiary healthcare center.MethodsWe performed a retrospective cohort study of clinical data at Stanford University, assessing all WnH patients under 18 years old who received a primary ASD diagnosis at Stanford University. NamSor Application Programming Interface (API) was used to identify patients likely to be of MENA background. A manual chart review of identified patients was performed to confirm MENA identity. Welch’s unequal variances t test was used to compare the age at diagnosis between the 2 groups. Statistical significance threshold was set at p < .1.ResultsA total of 694 patients were included in the analysis, and 21 of those patients were confirmed to be of MENA background. The mean age at diagnosis for the MENA patients was 63.85 months (standard error = 5.57 months), compared to the mean age at diagnosis for WnH patients of 52.60 months (standard error = 1.38 months). Welch’s unequal variances t test analysis resulted in a two-tailed p value of .0627.ConclusionsDespite our relatively small sample size, we were able to show a trend toward ASD diagnosis at a later age for MENA-American patients compared to WnH patients. A well-powered study promises to uncover further health disparities that MENA-Americans face. We acknowledge some limitations in our study. We opted to optimize for specificity in identifying MENA patients at the expense of sensitivity, resulting in under-sampling of MENA-American patients. Moreover, our relatively small sample size limits the conclusions that we can extrapolate from this study. However, we strongly believe that these methodological limitations serve to support what we are trying to advocate for: healthcare systems, public health departments, and large health databases need to add a MENA demographic category in order to make it possible to conduct well-powered, nationally representative population health studies necessary to elucidate insight on the health status and health outcomes of MENA patients.DEI, DEMF, ADV ObjectivesPatients of Middle Eastern and Northern African (MENA) background are inappropriately categorized as White non-Hispanic (WnH) on census data. The lack of the MENA identifier is a barrier to conducting population health studies on MENA patients. This precludes MENA communities from essential federal and local funding opportunities, and tailored public health interventions. In this study, we use age at diagnosis of ASD as a proxy to assess disparities in access to care at a tertiary healthcare center. Patients of Middle Eastern and Northern African (MENA) background are inappropriately categorized as White non-Hispanic (WnH) on census data. The lack of the MENA identifier is a barrier to conducting population health studies on MENA patients. This precludes MENA communities from essential federal and local funding opportunities, and tailored public health interventions. In this study, we use age at diagnosis of ASD as a proxy to assess disparities in access to care at a tertiary healthcare center. MethodsWe performed a retrospective cohort study of clinical data at Stanford University, assessing all WnH patients under 18 years old who received a primary ASD diagnosis at Stanford University. NamSor Application Programming Interface (API) was used to identify patients likely to be of MENA background. A manual chart review of identified patients was performed to confirm MENA identity. Welch’s unequal variances t test was used to compare the age at diagnosis between the 2 groups. Statistical significance threshold was set at p < .1. We performed a retrospective cohort study of clinical data at Stanford University, assessing all WnH patients under 18 years old who received a primary ASD diagnosis at Stanford University. NamSor Application Programming Interface (API) was used to identify patients likely to be of MENA background. A manual chart review of identified patients was performed to confirm MENA identity. Welch’s unequal variances t test was used to compare the age at diagnosis between the 2 groups. Statistical significance threshold was set at p < .1. ResultsA total of 694 patients were included in the analysis, and 21 of those patients were confirmed to be of MENA background. The mean age at diagnosis for the MENA patients was 63.85 months (standard error = 5.57 months), compared to the mean age at diagnosis for WnH patients of 52.60 months (standard error = 1.38 months). Welch’s unequal variances t test analysis resulted in a two-tailed p value of .0627. A total of 694 patients were included in the analysis, and 21 of those patients were confirmed to be of MENA background. The mean age at diagnosis for the MENA patients was 63.85 months (standard error = 5.57 months), compared to the mean age at diagnosis for WnH patients of 52.60 months (standard error = 1.38 months). Welch’s unequal variances t test analysis resulted in a two-tailed p value of .0627. ConclusionsDespite our relatively small sample size, we were able to show a trend toward ASD diagnosis at a later age for MENA-American patients compared to WnH patients. A well-powered study promises to uncover further health disparities that MENA-Americans face. We acknowledge some limitations in our study. We opted to optimize for specificity in identifying MENA patients at the expense of sensitivity, resulting in under-sampling of MENA-American patients. Moreover, our relatively small sample size limits the conclusions that we can extrapolate from this study. However, we strongly believe that these methodological limitations serve to support what we are trying to advocate for: healthcare systems, public health departments, and large health databases need to add a MENA demographic category in order to make it possible to conduct well-powered, nationally representative population health studies necessary to elucidate insight on the health status and health outcomes of MENA patients.DEI, DEMF, ADV Despite our relatively small sample size, we were able to show a trend toward ASD diagnosis at a later age for MENA-American patients compared to WnH patients. A well-powered study promises to uncover further health disparities that MENA-Americans face. We acknowledge some limitations in our study. We opted to optimize for specificity in identifying MENA patients at the expense of sensitivity, resulting in under-sampling of MENA-American patients. Moreover, our relatively small sample size limits the conclusions that we can extrapolate from this study. However, we strongly believe that these methodological limitations serve to support what we are trying to advocate for: healthcare systems, public health departments, and large health databases need to add a MENA demographic category in order to make it possible to conduct well-powered, nationally representative population health studies necessary to elucidate insight on the health status and health outcomes of MENA patients.