Patients with High Educational Attainment Are More Likely to Have Screening for Hepatitis C Virus

Introduction Approximately 3 million people in the United States are afflicted with chronic Hepatitis C virus (HCV) infection. Infection is most prevalent in patients born between 1945-1965, and the African American community is disproportionately affected. A screening test is available and recommended, but many patients with HCV infection are unaware that they are infected. There are many obstacles to obtaining preventative care, and a lower level of education has been associated with decreased access. This study evaluated the impact of education level on access to HCV screening in a historically underserved community. Methods Individuals attending a health exposition in August 2015 sponsored by the Rodham Institute completed an anonymous survey. The exposition was hosted in an urban setting with a predominantly African-American population. The survey included questions regarding demographics, access to care, insurance status, and HCV screening and awareness. Responses were excluded if education level was not specified or any questions went unanswered. Statistical analysis was performed using Fisher’s exact test, with significance set at p \u3c 0.05. Results There were 102 respondents. Ninety-two (90.2%) completed the HCV screening and education questions and were included in the study. Thirty (32.6%) had a college degree; 19 (63.3%) of them had discussed HCV screening with their primary care providers. Sixty-two (68.8%) had high school education or less and 24 (38.7%) discussed HCV screening with their doctor (p\u3c0.0440). There were 27 respondents born between 1945 and 1965. Twelve (44.4%) had a college education and 15 (55.6%) had less. Within this cohort, 10 (83.3%) college-educated respondents and five (33.3%) of the others had discussed HCV screening with the primary doctor (p\u3c0.0185). Discussion The African-American population is disproportionately affected by HCV, and many of these patients are unaware of their infection status. Our study found that in this underserved community, those with higher education were more likely to discuss HCV screening with their primary care provider than those without. Interestingly, this trend was more pronounced among the 1945-1965 birth cohort, in whom universal screening is recommended. Although our study may be limited by a small sample size, it highlights that access to higher education may be associated with increased knowledge of HCV and availability of screening. It is imperative that physicians continue to discuss HCV screening with all at-risk patients in order to spread awareness and reduce morbidity. The study demonstrates that education is an important social determinant of health