Symposia
Health Care System / Public Policy
Taylor E. Penwell, PhD
Study Coordinator
University of Louisville
Louisville, Kentucky
Samantha P. Spoor, B.S.
Graduate Student
University of Wyoming
Laramie, Wyoming
Rebecca Eyre, M.A.
Chief Executive Officer
Project HEAL
Brooklyn, New York
Cheri Levinson, Ph.D.
Associate Professor
University of Louisville
Louisville, Kentucky
Objective: Despite having the second highest mortality rate of any psychological disorder (Keel et al., 2003; Smink, Van Hoeken, & Hoek, 2012), most individuals with an eating disorder (ED) never access treatment (Hart et al., 2011). While studies have begun to elucidate ED treatment access inequities (Innes, Clough, & Casey, 2016), several gaps in the literature persist: (1) comprehensively assessing systemic and intrapersonal treatment access barriers simultaneously, and (2) providing generalizable estimates of the prevalence of barriers to treatment access in the U.S.. Therefore, the current study (N = 1,739) extends previous research by quantifying barriers to treatment access in the EDs across several domains, including self-reported lifetime financial, diagnostic, treatment quality, sociocultural, and geographical barriers in a large sample consisting of participants from all 50 U.S. states, and territories.
Methods: Participants 18 years or older or guardians of those under 18 (N = 1,739; M age =29.6 ± 9.2) were recruited using social media advertisements to participate in a brief (5-10 minutes) online research study about lifetime ED treatment access and experiences on behalf of themselves or a dependent. Majority of the sample was White (N = 1488, 85.6%), cisgender women (N = 1,517, 87.2%), heterosexual (N = 1006, 57.8%), and reported anorexia nervosa as their primary eating disorder diagnosis (N = 526, 30.2%). Frequencies for each barrier domain were calculated.
Results: The most endorsed barrier domain was lifetime financial (N = 1378; 79.2%). Frequency of endorsement for other domains included 79% for diagnostic (N = 1374), 65.2% for treatment quality (N = 1133), 59.7% for sociocultural (N = 1039), and 38.6% geographical barriers (N = 671).
Conclusions:
The current study extends existing research by (1) recruiting a large sample, (2) providing generalizable estimates for systemic and intrapersonal barriers to treatment access, and (3) including questions regarding accessing quality ED treatment. Future research should examine the long-term impact of treatment access and quality barriers on illness trajectory and identify how treatment access differs between diverse identities.