Background:

Research on healthcare access barriers among sexual and gender minority (SGM) individuals and racial/ethnic minorities with low back pain (LBP) in the United States remains limited. This study compared cost-related and non-cost–related barriers to care among SGM and non- SGM adults with LBP across racial/ethnic groups.

Methods:

We conducted a cross-sectional analysis of deidentified healthcare access and utilization survey data from the All of Us Research Program (May 6, 2018–July 1, 2022). Adults aged ≥18 years with LBP were included. Exposures included SGM status and self-reported race/ ethnicity (non-Hispanic Black [NHB], non-Hispanic White [NHW], Hispanic/Latino [HL]). Outcomes were cost-related and non-cost–related barriers to healthcare access. Multivariable logistic regression assessed associations between SGM status, race/ethnicity, and barriers to care.

Results:

Among 25,597 adults with LBP (2,169 [8.5%] SGM), SGM patients had higher odds of delaying mental health visits (aOR 1.72; 95% CI 1.50–1.97), prescription filling (aOR 1.27; 95% CI 1.13–1.43), and specialist care (aOR 1.18; 95% CI 1.02–1.35) due to cost, as well as reporting inability to take time off work (aOR 1.18; 95% CI 1.03–1.36), transportation barriers (aOR 1.36; 95% CI 1.18–1.56), and perceived disrespect (aOR 1.40; 95% CI 1.27–1.54). Compared with NHW patients, NHB and HL patients more frequently delayed care due to cost and experienced transportation and work-leave barriers. HL SGM patients had over twice the odds of delaying care (aOR 2.41; 95% CI 1.61–3.62) compared with NHW non-SGM patients.LBP (2,169

Conclusion:

SGM, HL, and NHB adults with LBP experience disproportionate barriers to healthcare access, underscoring the need for targeted strategies to promote equity in pain-related care