Abstracts

Rationale: Many studies have been conducted looking at health disparities in chronic diseases such as diabetes and heart disease. However, there have only been a limited number of studies done to evaluate possible health disparities in adult epilepsy. The purpose of this study was to review admissions to the University of Alabama at Birmingham seizure monitoring unit (SMU) over the past ten years in order to identify possible health disparities in this population.Methods: This study retrospectively reviewed initial admissions to the SMU from January 1, 2000 to December 31, 2010. Variables collected included race, gender, date of birth, primary diagnosis, zip code, estimated annual household income and distance to UAB. Geocoding by zip code was performed to determine possible gaps or barriers in geographical access to treatment. These demographic factors were analyzed to characterize the SMU population. Results: There were 3622 admissions to the SMU from 2000 to 2010. These patients were 66% female, with a mean age of 40 13.8 years. The population was 78 % Caucasian, 19% African-American, and 3% other. 88.6% of Caucasians represented a household income greater than $45,000. The average distance traveled to UAB was 85 miles. Patients represented all 67 counties in Alabama, with 53% originating from urban counties. Caucasians were 4 times more likely to be from rural counties. The most common epilepsy diagnosis was temporal lobe epilepsy (16%). Among those patients with temporal lobe epilepsy, Caucasians were 2.4 times more likely to receive surgical intervention for their condition. Conclusions: Within our study population, there are evident racial disparities with regard to income and likelihood of surgical intervention. African Americans in general earned less and were operated on less often than Caucasian patients were. There was also a gender disparity, as the patient population was only 34% male. These findings suggest that there are both racial and gender disparities in the evaluation and care of epilepsy patients in the state of Alabama.