Objective:

To investigate the impact of health care-seeking behaviors on geographic disparities in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) prevalence using an agent-based model (ABM), highlighting the significance of these behaviors in understanding health disparities.

Key Findings:

• The ABM reproduced prevalence data for 9 out of 21 geographies, indicating some level of accuracy.
• Simulated geographic differences in prevalence did not match the magnitude of observed data, suggesting limitations in the model's assumptions.
• Spatial patterns showed low to moderate agreement with empirical observations, raising questions about the underlying factors influencing these patterns.

Interpretation:

Geographic disparities in CA-MRSA prevalence identified in EHR data may stem from factors beyond bias and health care-seeking behaviors, suggesting a need for further investigation into other determinants such as socioeconomic factors and access to care.

Limitations:

• The model assumes no initial differences in disease prevalence, which may not reflect real-world conditions and could introduce bias.
• The ABM's simulated outcomes did not fully replicate observed geographic disparities, indicating potential limitations in the model's design and data inputs.

Conclusion:

Future studies could adapt the ABM for other health outcomes by modifying health care-seeking behavior parameters and disease progression processes, thereby enhancing our understanding of health disparities.