A systematic literature review of health disparities among rural people with epilepsy (RPWE) in the United States and Canada

Sean M. Duke; Karina A. González Otárula; Thomas Canales; Elaine Lu; Amber Stout; Gena R. Ghearing; Martha Sajatovic

doi:10.1016/j.yebeh.2021.108181

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A systematic literature review of health disparities among rural people with epilepsy (RPWE) in the United States and Canada

Journal article

Peer reviewed

A systematic literature review of health disparities among rural people with epilepsy (RPWE) in the United States and Canada

Sean M. Duke, Karina A. González Otárula, Thomas Canales, Elaine Lu, Amber Stout, Gena R. Ghearing and Martha Sajatovic

Epilepsy & behavior, Vol.122, pp.108181-108181

09/2021

DOI: 10.1016/j.yebeh.2021.108181

PMCID: PMC8429139

PMID: 34252832

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https://www.ncbi.nlm.nih.gov/pmc/articles/8429139View

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Abstract

•Epilepsy can be burdensome for patients, families, health systems, and society.•Health disparities of people with epilepsy can be worsened by living in rural areas.•Demographics and socioeconomic status drive the poor outcomes, not rurality per se.•Prospective studies with standard definitions of rural are needed. Epilepsy is a leading cause of global disease burden, with people with epilepsy (PWE) experiencing adverse health outcomes related to the psychiatric comorbidities and socioeconomic consequences of the disorder. Rural populations are more likely to be impoverished or uninsured, which could impact health outcomes for rural-dwelling PWE (RPWE). This systematic literature review identified original research studying health disparities and outcomes among RPWE in the United States and Canada to (1) characterize the disparities faced by RPWE and (2) elucidate the effects of these disparities upon clinical outcomes. We performed a systematic search of six electronic databases: Pubmed, Cochrane, PsychInfo, Web of Science, Scopus, and Ovid. Articles considered were original research reports conducted in Canada or the United States before August 2020. A modified Newcastle Ottawa Scale was used to assess the quality of the included studies. Our search returned 2093 articles that examined the health disparities of RPWE, of which six met criteria for this review. Outcome measures of health disparity included in these papers were mortality (2; 33%), use of health resources (2; 33%), and epilepsy prevalence (2; 33%). Only one paper (16%) concluded that RPWE experienced worse health outcomes relative to urban-dwelling PWE, while 5 (84%) found no difference. Our study did not find sufficient evidence that RPWE in the US and Canada experience significant health disparities compared to similar urban populations of PWE. More research using prospective studies and datasets allowing better characterization of rurality is required.

Epilepsy

Inequities

Mortality

Rural

Under-served

Details

Title: Subtitle: A systematic literature review of health disparities among rural people with epilepsy (RPWE) in the United States and Canada
Creators: Sean M. Duke - University Hospitals of Cleveland
Karina A. González Otárula - Department of Neurology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA
Thomas Canales - University Hospitals of Cleveland
Elaine Lu - University Hospitals of Cleveland
Amber Stout - University Hospitals of Cleveland
Gena R. Ghearing - University of Iowa
Martha Sajatovic - University Hospitals of Cleveland
Resource Type: Journal article
Publication Details: Epilepsy & behavior, Vol.122, pp.108181-108181
DOI: 10.1016/j.yebeh.2021.108181
PMID: 34252832
PMCID: PMC8429139
NLM abbreviation: Epilepsy Behav
ISSN: 1525-5050
eISSN: 1525-5069
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100000025, name: National Institute of Mental Health
Language: English
Date published: 09/2021
Academic Unit: Neurology
Record Identifier: 9984303018102771

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