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Review
. 2017 May 28;2(4):187-193.
doi: 10.1002/lio2.81. eCollection 2017 Aug.

Disparities in health in the United States: An overview of the social determinants of health for otolaryngologists

Regan W Bergmark  1   2 , Ahmad R Sedaghat  1   2
Affiliations
Review

Disparities in health in the United States: An overview of the social determinants of health for otolaryngologists

Regan W Bergmark et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objectives: Social determinants of health include social and demographic factors such as poverty, education status, race and ethnicity, gender, insurance status, and other factors that influence (1) development of illness, (2) ability to obtain and utilize healthcare, and (3) health and healthcare outcomes. In otolaryngology, as in other subspecialty surgical fields, we are constantly confronted by patients' social and demographic circumstances including poverty, language barriers, and lack of health insurance and yet there is limited research on how these factors impact health equity in our field, or how attention to these patient characteristics may improve health equity. This review provides the reader with a framework to understand the social determinants of health including how socioeconomic status, insurance status, race, gender, and other factors impact health.

Data sources and review methods: Foundational papers on the social determinants of health are reviewed, as well as otolaryngology publications focused on health and healthcare disparities.

Results: The social determinants of health have a major impact on patient health as well as healthcare utilization, but there is a relative lack of data on these factors and how they can be addressed within otolaryngology. Incorporating tools to measure social and demographic characteristics and actually report on these measures is a first simple step to increase the data on the social determinants of health as they pertain to otolaryngology.

Conclusion: More research is needed on the social determinants of health, and how they impact otolaryngic disease. Medicare's Accountable Care Organization models will increasingly change the way in which physicians are reimbursed, making the social determinants of health central not only to our moral conscience but also the bottom line.

Level of evidence: 4.

Keywords: Healthcare disparities; Medicaid; healthcare delivery; insurance; primary care; socioeconomic factors; uninsured.

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Figures

Figure 1
Figure 1
Clinical vignette 1.
Figure 2
Figure 2
Clinical vignette 2.
See this image and copyright information in PMC

References

    1. Braveman PA, Kumanyika S, Fielding J, et al. Health disparities and health equity: The issue is justice. Am J Public Health 2011;101(Suppl 1):S149–55. - PMC - PubMed
    1. Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care. JAMA 2000;283:2579–2584. - PubMed
    1. Liederbach E, Kyrillos A, Wang CH, Liu JC, Sturgis EM, Bhayani MK. The national landscape of human papillomavirus‐associated oropharynx squamous cell carcinoma. Int J Cancer 2017;140:504–512. - PubMed
    1. Braveman PA, Egerter SA, Woolf SH, Marks JS. When do we know enough to recommend action on the social determinants of health? Am J Prev Med 2011;40(Suppl 1):S58–66. - PubMed
    1. Braveman PA, Egerter SA, Mockenhaupt RE. Broadening the focus: The need to address the social determinants of health. Am J Prev Med 2011;40(Suppl 1):S4–18. - PubMed