“First Understand Health Care Disparities to Address Them Correctly”

Junko Takeshita, MD, presented “Health Disparities in Dermatology: Psoriasis,” during Spring Dermatology Week 2023.

Dr Takeshita is an assistant professor of dermatology and epidemiology in biostatistics and epidemiology at the University of Pennsylvania in Philadelphia, PA. Her session objectives included defining disparities in health and health care and summarizing racial and ethnic disparities related specifically to psoriasis. She also outlined approaches to address these disparities.

Having a thorough understanding of heath disparities is critical, Dr Takeshita said. The National Institutes of Health defines health disparity as “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.”

Dr Takeshita indicated that health disparities are a global problem and addressing them can reduce costs and protect minority groups. Social determinants of health, such as economic stability, neighborhood and physical environment, education levels, access to food and nutrition, community and social contexts, and health care systems greatly affect health outcomes.

“Research is essential to develop a framework to detect, understand, and ultimately reduce or even eliminate health disparities,” Dr Takeshita noted. By intervening in a timely manner, evaluating the problems, and implementing policy changes, the nation can bridge the gap in health and health care in an evidence-based manner.

Speaking about plaque psoriasis in different skin tones, the intersection between race, ethnicity, and skin type is an important and unique consideration. Although the general concerns about psoriasis, such as visibility, emotional toll, worsening of the disease, and physical symptoms, remain similar between White and Black patients, Black patients are more concerned about scarring or discoloration and lack of a cure, whereas White patients are more worried about comorbid diseases and hereditary factors.

Dr Takeshita provided guidance on select treatment and management considerations. For scalp psoriasis among people with dryer or curlier hair, she advised to avoid hair treatments that require frequent hair washing. Oils and ointments are preferred to maintain moisture, she said. Additionally, phototherapy should be provided in higher doses for darker skin types for better results.

“Psoriasis is common across all races, ethnicities, and skin tones,” Dr Takeshita said. “Equitable psoriasis care requires accurate and timely diagnosis, adequate education about the diseases and treatment options, and a culturally mindful approach to medical management.”

Reference
Takeshita J. Health disparities in dermatology: psoriasis. Presented at: Dermatology Week; May 3–6; Virtual.