ACCESS
Cultural Stereotypes and medical bias hamper access to assessment and treatment of sleep disorders for underserved communities.
Implicit bias in medical care shows up in the belief that treatments developed in clinical studies involving primarily white subjects is effective for all others. This shows up in a variety of manners-pulse oxygen sensors are not as effective in reading people who have darkened skin (18); Racial and ethnic disparities exist in the utilization of tonsillectomy and adenoid surgery (T&A) for children with Sleep Disordered Breathing enrolled in Medicaid (19).
Cultural sterotypes of treatment for sleep apnea -black people won't use cpap or clean it. (Dr. Patel)
Oximeter accuracy for people with dark skin -https://arstechnica-com.cdn.ampproject.org/c/s/arstechnica.com/science/2022/09/dangerously-wrong-oxygen-readings-in-dark-skinned-patients-spur-fda-scrutiny/?amp=1
a. https://www.warren.senate.gov/oversight/letters/senators-warren-booker-and-wyden-urge-fda-to-address-concerns-about-dangerous-pulse-oximeter-inaccuracies-for-patients-of-color
FROM DR. PATEL
Cultural competence among sleep medicine team as an advocacy issue to improve the engagement.
Treatments are not designed for different ethnicities-Companies have piloted the design of masks not for black or Latino populations. Dr. Patel. This is also seen in pediatric tonsillectomy. Black children fail at tonsillectomy's more than white kids-worse outcomes. Is this an anatomic problem or what are the other issues
Less access to treatment is a systematic issue-Every insurance allows you to do hst. HST is cheaper but Medicare and Medicaid don't allow for HST and this hampers the access to minoritiezed populations. Transportation issues for those who are socioeconomicly challneged (childcare, shift work)
Trust in sleep medicine-Study out of UIC about how black people prefer HST to sleeping in a foreign place and people watching you which is a holdover effect of medicine taking advantage of blacks through history. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106942/
Affordability and access to assessment, diagnosis and treatment for socioeconomically challenged minoritized populations-copays, location of assessments, supports for treatment success, affordability of devices with oxygen measurement (Digital equity issue)
Access to tonsilectomys for black and latino downsyndrome children who have sleep apnea
Cultural sterotypes of treatment for sleep apnea
Oximeter accuracy for people with dark skin -https://arstechnica-com.cdn.ampproject.org/c/s/arstechnica.com/science/2022/09/dangerously-wrong-oxygen-readings-in-dark-skinned-patients-spur-fda-scrutiny/?amp=1
a. https://www.warren.senate.gov/oversight/letters/senators-warren-booker-and-wyden-urge-fda-to-address-concerns-about-dangerous-pulse-oximeter-inaccuracies-for-patients-of-color
Brown Ph.D. student working to correct skin color bias in pulse oximeters
Pulse oximeters often provide inaccurate readings for people with darker skin, a significant health disparity that physics Ph.D. student Rutendo Jakachira is working to eliminate.
