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Review
. 2022 Dec:188:107038.
doi: 10.1016/j.eplepsyres.2022.107038. Epub 2022 Oct 20.

A framework for health equity in people living with epilepsy

Wyatt P Bensken  1 , Philip M Alberti  2 , Omar I Khan  3 , Scott M Williams  4 , Kurt C Stange  5 , Guadalupe Fernandez-Baca Vaca  6 , Barbara C Jobst  7 , Martha Sajatovic  8 , Siran M Koroukian  9
Affiliations
Review

A framework for health equity in people living with epilepsy

Wyatt P Bensken et al. Epilepsy Res. 2022 Dec.

Abstract

Epilepsy is a disease where disparities and inequities in risk and outcomes are complex and multifactorial. While most epilepsy research to date has identified several key areas of disparities, we set out to provide a multilevel life course model of epilepsy development, diagnosis, treatment, and outcomes to highlight how these disparities represent true inequities. Our piece also presents three hypothetical cases that highlight how the solutions to address inequities may vary across the lifespan. We then identify four key domains (structural, socio-cultural, health care, and physiological) that contribute to the persistence of inequities in epilepsy risk and outcomes in the United States. Each of these domains, and their core components in the context of epilepsy, are reviewed and discussed. Further, we highlight the connection between domains and key areas of intervention to strive towards health equity. The goal of this work is to highlight these domains while also providing epilepsy researchers and clinicians with broader context of how their work fits into health equity.

Keywords: Disparities; Epilepsy outcomes; Epilepsy risk; Inequities.

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Figures

Figure 1.
Figure 1.
Multilevel life course model highlighting how policies and practices set the stage for the interplay (dashed arrows represent two-way relationships) of structural, health care, socio-cultural, and physiological factors to create inequities (darker lines) in the risk of epilepsy development, diagnosis and treatment, and health and health outcomes.
Figure 2.
Figure 2.
Structural factors which influence inequities in epilepsy risk and outcomes
Figure 3.
Figure 3.
Socio-cultural factors, primarily positive social support and negative social support and stigma can influence inequities in epilepsy risk and outcomes.
Figure 4.
Figure 4.
Health care factors which influence inequities in risk and outcomes for people with epilepsy
Figure 5.
Figure 5.
Physiological factors which influence inequities in epilepsy risk and outcomes.
See this image and copyright information in PMC

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