Investigators summarized factors reducing access to care among sexual and gender minority patients with chronic inflammatory skin diseases, according to a recent study published by Nock et al in JAMA Dermatology. In a cross-sectional study, the investigators used the National Institutes of Health All of Us Research Program to analyze survey data collected from nearly 20,000 patients with chronic inflammatory skin diseases—1,877 of whom identified as sexual and gender minority individuals. They then determined the patients’ access and utilization to health-care services between May 2017 and July 2022. The investigators found that compared with non–sexual and gender minority patients, sexual and gender minority patients were more likely to experience cost- and noncost-related barriers to care. For instance, sexual and gender minority patients were more likely to delay specialist care (adjusted odds ratio [OR] = 1.23, 95% confidence interval [CI] = 1.03–1.47), mental health care (adjusted OR = 1.62, 95% CI = 1.37–1.91), and filling prescriptions (adjusted OR = 1.30, 95% CI = 1.11–1.52) as a result of costs; and were also more likely to delay care because of transportation issues (adjusted OR = 1.49, 95% CI = 1.22–1.80). Further, sexual and gender minority patients were also found to be at a higher risk of delaying care because they weren’t treated with respect (adjusted OR = 1.47, 95% CI = 1.30–1.65) or because they lacked a physician with the same race, ethnicity, religion, native language, sexual orientation, and gender identify as them (adjusted OR = 1.39, 95% CI = 1.19–1.62). The investigators also reported that non-Hispanic Black, Hispanic, and Latino patients were at higher risk of experiencing barriers to care. The investigators underscored the need to address systemic issues to improve access to care for sexual and gender minority patients with chronic inflammatory skin diseases.


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