Hello, my name is Gayathri Rothode, and I will be presenting on the examination of health disparities present in Haitian patients at the BCOM clinics in Punta Cana, Dominican Republic. My name is Gayathri. My collaborators are Juhi Patel, Elena Varnadoe, and Dr. Tom Lindsay. Haiti and the Dominican Republic have an intricate and complicated political history that particularly affects the numerous Haitian migrants that seek refuge in the Dominican Republic in pursuit of a better life. This complexity particularly affects access to health care for these migrants, even though there's a law that mandates health care provision. And this is due to a lack of health care education and resources for these populations, along with stigma and discrimination surrounding HIV, for example, that is more prominent within the Dominican population. Given the presence of BCOM clinics in Punta Cana, in the Dominican Republic, these tensions and migration challenges emphasize the importance of ensuring equitable health care access for all patients there. So we conducted this study to understand and discover if differences in health utilization exist between the local Dominican population and Haitian refugees at the BCOM-sponsored clinics concerning diagnosis, visit type, and frequency of clinic use. This was a retrospective chart review on our Credo data platform spanning one year, from October 2022 to October 2023, where over 88,400 electronic case reports for patients of Haitian and Dominican nationality were studied. This data was de-identified, and variables collected included age, type of visit, emergency inpatient follow-up, diagnosis codes, as well as social determinants of health, like food insecurity, housing, clean water, and preventative care. Both the adult and pediatric populations were considered, along with categorical variables that were compared using chi-squared tests to test health differences by nationality of either Dominican or Haitian. Prevalence and incidence rates were calculated, and diagnosis codes were grouped based on literature, assessing social determinants of health, such as food insecurity, water conditions, housing, and preventative care. So this was a data-driven, osteopathic, holistic approach to understanding the health needs of a vulnerable international population, with attention to social determinants of health and population-specific needs, along with prevention of chronic diseases. So in our results, first it's important to take a look at what the population demographics for these 40,000 patients in this one-year time period were, given that this is a patient population that is predominantly uninsured. Over 85 percent, about 85 percent of the Dominican patients there, and 93 percent of the Haitian population there at the free clinics did not have other insurance, and likely did not have data at other hospitals. We had a pretty even spread between male and female, but both populations also had a higher pediatric attendance in patient-seeking care. If you look down here, we can see the top diagnoses that were documented within this one-year period, and HIV emerged as the most frequent reason for adult visits to the hospital. HIV emerged as the most frequent reason for adult visits to the VCOM clinics between October 2022 and 2023. For Dominican individuals, the prevalence of primary care diagnoses and preventative care was a lot higher, versus Haitian patients exhibited more curative care-seeking habits, including rates of HIV, which were 7.7 versus 3.5. Injuries and abdominal pain. In the pediatric disparities, again, you can see a higher prevalence in preventable care for the Dominican population, and parasitics being a little bit, and obesity and iron-deficient anemia being more prevalent for the Haitian population. And then when you look at HIV disparities by drug burden, you can still see the higher burden for a Haitian population. So, in conclusion, the evaluation of health disparities at the VCOM clinics reveals significant findings addressing the data gap amongst the Haitian and Dominican communities there, which promotes a special consideration for enhanced HIV prevention efforts, including educational resources in Creole, which the Haitian populations in the Dominican predominantly speaks, as well as efficacy and access to PrEP. Meanwhile, Haitian housing may exhibit inadequate living conditions and lack of clean water due to their increased parasitic and malnutrition diagnoses codes, along with higher levels of food insecurity. In conclusion, assessing health disparities at the VCOM clinics has highlighted insights into challenges in healthcare faced by both the Dominican and Haitian communities. Thank you.

health disparities

Haitian patients

HIV prevalence

social determinants

VCOM clinics