Chronic Viral Hepatitis Screening Inequities Across Florida Federally Qualified Health Centers

Hannah M Cranford; Daniel Parras; Patricia D Jones; Edelise Endemano; Katherine Chung-Bridges; Paulo S Pinheiro

doi:10.1007/s40615-025-02363-3

Chronic Viral Hepatitis Screening Inequities Across Florida Federally Qualified Health Centers

J Racial Ethn Health Disparities. 2025 Mar 6. doi: 10.1007/s40615-025-02363-3. Online ahead of print.

Authors

Hannah M Cranford¹, Daniel Parras², Patricia D Jones^{3

4}, Edelise Endemano², Katherine Chung-Bridges², Paulo S Pinheiro^{5

4}

Affiliations

¹ Division of Epidemiology & Population Health Sciences, Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, USA. Hmc110@miami.edu.
² Health Choice Network, Miami, FL, USA.
³ Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami School of Medicine, Miami, FL, USA.
⁴ Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, USA.
⁵ Division of Epidemiology & Population Health Sciences, Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, USA.

PMID: 40048081
DOI: 10.1007/s40615-025-02363-3

Abstract

Aim: Examine racial and ethnic inequities in hepatitis C and B virus (HCV and HBV) screening across high-risk populations.

Subject and methods: Chronic HCV and HBV infections can lead to cirrhosis, hepatocellular carcinoma (HCC), and death. Despite universal screening recommendations, < 50% of US adults are tested for these viruses. Populations with lower socio-economic status experience higher rates of viral-related cirrhosis and HCC, which may be reduced through screening and treatment. This study analyzed data from 91,875 patients (2019-2021) at the Health Choice Network, a federally qualified health center in Florida. Logistic regression assessed the determinants of HCV and HBV screening, considering factors such as age, sex, language, and race/ethnicity.

Results: The study population was predominantly female, Hispanic, uninsured, and living below the federal poverty line. Overall, 61.7% had HCV screening, and 43.7% had HBV screening. Haitian Creole-speaking patients (aOR 1.67; 95% CI, 1.50-1.85), Asian (aOR 1.41; 95% CI, 1.26-1.58), Spanish-speaking Hispanic (aOR 1.38; 95% CI, 1.32-1.44), and English-speaking Hispanic patients (aOR 1.12; 95% CI, 1.07-1.18) had higher odds of HCV screening, compared to NH-Whites. Similarly, Haitian Creole-speaking (aOR 1.91; 95% CI, 1.73-2.12), Asian (aOR 1.50; 95% CI, 1.33-1.68), and Spanish-speaking Hispanic patients (aOR 1.23; 95% CI, 1.17-1.29) had higher odds of HBV screening.

Conclusion: For an underserved population context, screening rates were above average, with higher prevalence among historically disadvantaged populations. However, rates remained suboptimal, particularly among NH-Whites, who account for the largest number of HCV-related liver cancers, often linked to injection drug use. Increasing screening, especially among NH-Whites and English-speaking Hispanics for HCV, is crucial for early diagnosis, treatment, and reducing severe liver disease risk, including cirrhosis and HCC.

Keywords: Ethnicity; Federally qualified health center; HBV; HCV; Race; Screening.

Grants and funding

20B16/Florida Department of State