Ethnoracial Disparities Seen in Access to Genetic Testing in Pediatric Neurology

White pediatric neurology patients more likely to have completed one or more genetic test than Black patients

By Elana Gotkine HealthDay Reporter

THURSDAY, Feb. 13, 2025 (HealthDay News) — For pediatric neurology patients, there are marked ethnoracial disparities in genetic testing completion, according to a study published online Feb. 12 in Neurology.

Jordan Janae Cole, M.D., from the University of Colorado in Aurora, and colleagues examined whether social determinants of health (SDOH) are associated with genetic testing among pediatric neurology outpatients in a retrospective observational study using electronic health record data. Genetic testing requests, insurance denials, and test completion rates were compared for non-Hispanic single-racial or multiracial Black versus non-Hispanic single-racial White patients.

Data were included for 11,371 patients, of whom 4.9 percent completed one or more genetic test in the study interval. The researchers found that compared with Black patients, White patients were significantly more likely to have completed one or more genetic test (adjusted odds ratio, 1.88). The most common specialty through which testing was completed was outpatient pediatric neurology. There was no difference seen in neurology provider request rates for genetic testing by patient ethnoracial identity; lower insurance denial rates after neurology request were seen for White versus Black patients (relative rate ratio, 0.44); the likelihood of completing genetic testing after it was requested through neurology was lower for those with public insurance (adjusted odds ratio, 0.59). Insurance type was significantly associated only with multipanel gene completion when considering individual genetic test types (public versus private: odds ratio, 0.56).

“Recognizing ethnoracial inequities and the barriers to genetic testing due to SDOH are essential for developing interventions to eliminate testing disparities, such as improving insurance coverage and increasing availability of point-of-care genetic testing,” the authors write.

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