Sociodemographic Predictors of Viral Load Testing Among Hepatitis C Antibody-Positive Patients in a Large Southern California County: An Example of Health Care Inequalities

Abstract

Purpose

The study examines health care inequities in viral load testing among hepatitis C (HCV) antibody-positive patients. The analysis predicts whether individual and census tract sociodemographic characteristics impact the likelihood of viral load testing.

Methodology/Approach

This a study of 26,218 HCV antibody-positive patients in Orange County, California, from 2010 to 2020. The case data were matched with the 2017 American Community Survey to help understand the role of neighborhood socioeconomic characteristics in testing for viral load. Multivariable logistic regression was used to predict the probability of ever testing for HCV viral load.

Findings

Thirty-six percent of antibody-positive persons were never viral load tested. The results show inequalities in viral load testing by sociodemographic factors. The following groups were less likely to ever test for viral load than their counterparts: (1) individuals under 65 years old, (2) females, (3) residents of census tracts with lower levels of health insurance enrollment, (4) residents of census tracts with lower levels of government health insurance, and (5) residents of census tracts with a higher proportion of non-white residents.

Research Limitations/Implications

This is a secondary database from public health department reports. Using census tract data raises the issue of the ecological fallacy. Detailed medical records were not available. The results of this study emphasize the social inequality in viral load testing for HCV. These groups are less likely to be treated and cured, and may spread the disease to others.

Originality/Value

This chapter is unique as it combines routinely collected public health department data with census tract level data to examine social inequities associated with lower rates of HCV viral load testing.

Citation

Goodman, S.H., Zahn, M., Bruckner, T.-A., Boden-Albala, B., Hankin, J.R. and Lakon, C.M. (2023), "Sociodemographic Predictors of Viral Load Testing Among Hepatitis C Antibody-Positive Patients in a Large Southern California County: An Example of Health Care Inequalities", Kronenfeld, J.J. (Ed.) Social Factors, Health Care Inequities and Vaccination (Research in the Sociology of Health Care, Vol. 40), Emerald Publishing Limited, Leeds, pp. 137-150. https://doi.org/10.1108/S0275-495920230000040008