In a retrospective analysis of more than 200,000 patients, minority patients living in high socially vulnerable neighborhoods had a 40% increased risk of a complication and a 23% increased risk of 90-day mortality compared to white patients for neighborhoods with low social vulnerability. The U.S. Centers for Disease Control and Prevention (CDC) defines social vulnerability as “potential negative effects on communities caused by external stresses on human health.”
The study was selected for the 2020 Southern Surgical Association Program and published in the Journal of the American College of Surgeons.
This study speaks to how health care and health outcomes extend beyond the doors of the hospital and even beyond the specifics of the disease the patient may have. Ultimately, the resources in the patient’s community may be as important to the patient’s health as what goes on in the hospital,” says Timothy Pawlik, MD, PhD, MPH, senior author of the study and holder of the Urban Meyer III and Shelley Meyer Chair for Cancer Research at the OSUCCC – James. Pawlik is surgeon-in-chief at the Ohio State Wexner Medical Center and chair of the Department of Surgery in Ohio State’s College of Medicine.
“This issue is not new, but the data strongly suggests we could significantly improve surgical outcomes by integrating vulnerability assessments into our national standard of care models. By doing so, we could help identify the most vulnerable among us — upfront — and provide additional supports as patients move through treatment and recovery,” Pawlik adds. “The data emphasizes how efforts to improve outcomes for cancer patients need to extend beyond the hospital and address systemic health-related disparities within the communities in which patients live.”
For this study, researchers used the social vulnerability index (SVI) risk-stratification tool, a composite measure of 15 social and economic factors. Although the CDC created the SVI using census data to identify communities needing greater support during disasters, researchers recently have applied it to medical studies.
They found that minority patients with high SVI scores had a 47% increased chance of an extended length-of-stay, 40% increased odds of a surgical complication and 23% increased odds of 90-day mortality.