Health disparities among adults with voice problems in the United States

Abstract

Objective: To assess differences in access to care and healthcare utilization among adults who reported voice problems in 2012.

Study design: Cross-sectional study.

Methods: The 2012 National Health Interview Survey was utilized to evaluate adults who had a "voice problem in the past 12 months." Multivariate analyses determined the influence of sociodemographic variables on the prevalence of voice problems in adults and access to care.

Results: Among 243 million adults in the United States, 17.9 ± 0.05 million adults (7.63% ± 0.21%) report experiencing voice problems. After controlling for age, education, income level, geographic region, and health insurance status, African Americans (odds ratio [OR]: 0.83, P < 0.05), Hispanics (OR: 0.61, P < 0.01), and other minorities (OR: 0.69, P < 0.01) had a lower OR for reporting voice problems in the last year relative to white adults. Among adults with voice problems, Hispanics were more likely to delay care because they could not reach a medical office by telephone (OR: 1.85, P < 0.01) and due to long wait times at the doctor's office (OR: 2.04, P < 0.01) compared to white adults. Adults with voice problems who were a racial minority, low income, or had public health insurance were more likely to postpone care because they lacked a mode of transportation.

Conclusion: Targeted programs are necessary to address the health disparities and barriers to care among those who suffer from voice problems.

Level of evidence: IV. Laryngoscope, 128:915-920, 2018.

Keywords: Voice disorder; dysphonia; health disparities; healthcare access; voice problems.