Social Determinants of Health in Surgery

A Primer for the Practicing Surgeon

1st Edition - September 27, 2023
Editors: Samilia Obeng-Gyasi, Timothy M. Pawlik
Language: English
Paperback ISBN:
9 7 8 - 0 - 4 4 3 - 1 2 3 6 6 - 5
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 1 2 3 6 7 - 2

“Social determinants of health” has been defined by the World Health Organization as the conditions in which people are born, grow, live, work, and age. These determinants can… Read more

Social Determinants of Health in Surgery

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“Social determinants of health” has been defined by the World Health Organization as the conditions in which people are born, grow, live, work, and age. These determinants can include factors such as housing, transportation, education, employment, and access to care. Social Determinants of Health: A Primer for the Practicing Surgeon provides a comprehensive, state-of-the art, definitive reference for the surgical community on this important topic, serving as an invaluable resource for surgeons, physicians, fellows, and residents.

Cover image
Title page
Table of Contents
Copyright
List of Contributors
Foreword
Preface
Chapter 1. Social Determinants of Health in Surgery Overview
Introduction
Access to Care
Poverty and Insurance
Food and Housing Insecurity
Systemic Racism and Allostatic Load
Education
Representation in Medicine
Section I. Theoretical Frameworks for Social Determinants of Health
Chapter 2. Internalizing Social Determinants of Health: The Ecosocial and Weathering Theories
An Introduction to Social Epidemiology
Ecosocial Theory
Discrimination: An Embodiment Pathway
Incorporating the Ecosocial Theory into Surgical Research
Weathering Hypothesis
Mechanisms Behind the Weathering Hypothesis
Application of the Weathering Hypothesis
Weathering in Surgical Research
Chapter 3. Allostatic Load—Measurement Issues in Cancer Patients and Other Populations
Introduction
Allostatic Load Theory and Conceptual Development
Allostatic Load in Cancer Populations
Measurement Issues in Allostatic Load
Case Example: Transdisciplinary Collaborative Center in Precision Medicine and Minority Men's Health
Conclusions and Future Directions
Chapter 4. The Conserved Transcriptional Response to Adversity: Prepared for Social Determinants of Health in Surgery
Introduction
Discovery of the Conserved Transcriptional Response to Adversity
Health Implications
Social Determinants of Health
Interventions
Measurement
Prospects
Section II. Social Determinants of Health in Surgery
Chapter 5. Finances as a Social Determinant of Health in Surgery
Introduction
A Brief Overview of Health Economics and the Complexity of Cost
The Patient Impact: Financial Toxicity
Long-Term Financial Impacts: Employment Disruption and Bankruptcy
What is High-Value Surgical Care and Why Does it Matter?
Building High-Value Surgery
The Future of Value-Based Surgical Care
Conclusions
Chapter 6. Neighborhood as a Social Determinant of Health in Surgery
Introduction
Commonly Used Measures of Neighborhoods
Neighborhood Designations Specific to Healthcare
Common Indexes to Measures Neighborhoods
How Might Neighborhoods Influence Surgical Outcomes?
Neighborhoods and Surgical Outcomes
Developing Areas of Neighborhoods and Surgical Outcomes
Chapter 7. Addressing the Social Determinants of Health to Enhance Clinical Trial Participation
Introduction
Current Data and Literature on Clinical Trial Participation
Barriers to Participation in Clinical Trials Underlying the Social Determinants of Health
Pathways and Mechanisms Through the Social Determinants of Health for Augmenting Recruitment and Retention in Clinical Trial Participation
Conclusion
Chapter 8. Race, Ancestry, and Social Determinants of Health in Surgery
Overview
Disparities in Surgical Management of Cancer Related to Race and SDOH
Germline Genetic Aspects of Race Related to Ancestry, SDOH, and Breast Cancer Burden
Conclusions
Chapter 9. Community Engagement as a Social Determinant of Health in Surgery
Identification of Social Determinants of Health
Government Response to Addressing Social Determinants of Health
Importance of Healthcare Provider Screening of Social Determinants of Health
Role of the Surgical Healthcare Provider in Community Engagement
Improving Representation in Clinical Trials
Role of Patient Advocacy in Community Engagement
Future Directions
Chapter 10. Insurance as a Social Determinant of Health in Surgery
Social Determinants of Health and Insurance Status
Insurance Basics and Recent Policy Advances
Discussion
Chapter 11. Health Literacy
What is Health Literacy?
Health Literacy as a Social Determinant of Health
Prevalence of Health Literacy
Health Literacy and the Practice of Surgery
Health Literacy Instruments
Limited Health Literacy Cost
Potential Challenges and Strategies to Address Health Literacy
Conclusions and Future Directions
Chapter 12. Psychological Stress and the Surgical Stressor
Introduction
Stressors and Stress Responses
Illness as a Stressor
Hospitalization and the Surgery Stressor
Preoperative Responses in Association with Outcomes
Stress Reduction to Reduce Anticipatory Stress and Improve Surgical Outcomes
Section III. Research
Chapter 13. Framing Theoretically Informed Social Determinants of Health Research Questions
Background
Theoretical Frameworks
Research on Social Determinants of Health
A Step-by-Step Guide on Framing Theoretically Informed Research Questions on SDH
Conclusion
Chapter 14. Social Determinants of Health: Study Designs and Outcomes
Introduction
Identifying the Research Question
Select the Study Population
Study Design
Select the Outcomes
Interpretation and Dissemination
Conclusion
Chapter 15. Interventions for Redressing Disparities Related to Social Determinants of Health in Surgery
Background
Data Collection
Patient Interventions
Provider Interventions
Systemic Interventions
Frameworks for Implementation of Equity-Focused Interventions
Next Steps
Chapter 16. Future Directions
Glossary of key terms
Index

Samilia Obeng-Gyasi

Samilia Obeng-Gyasi is Associate Professor of Surgery in the Division of Surgical Oncology, Department of Surgery at The Ohio State University, Wexner Medical Center, Columbus, OH, United States

Affiliations and expertise

Associate Professor of Surgery, Division of Surgical Oncology, Department of Surgery, The Ohio State University, Wexner Medical Center, Columbus, OH, United States

Timothy M. Pawlik

Dr. Pawlik received his undergraduate degree from Georgetown University and his medical degree from Tufts University School of Medicine. Dr. Pawlik completed surgical training at the University of Michigan Hospital and spent two years at the Massachusetts General Hospital as a surgical oncology research fellow. He then went on for advanced training in surgical oncology at The University of Texas M. D. Anderson Cancer Center in Houston. Dr. Pawlik’s main clinical interests include alimentary tract surgery, with a special interest in hepatic, pancreatic and biliary diseases. Dr. Pawlik also has an interest in medical ethics and completed a fellowship in medical ethics at the Harvard School of Public Health, as well as a Masters in Theology from Harvard Divinity School in Boston. In addition, Dr. Pawlik was the recipient of a Clinical and Translational Science Award (CTSA) KL2 Research Scholar Award and received a PhD from the Johns Hopkins Bloomberg School of Public Health in Clinical Investigations. Dr. Pawlik also received his Executive MBA Program from The Ohio State University Fisher Business School. Dr. Pawlik took his first faculty appointment at Johns Hopkins in 2005, where he was Professor of Surgery and Oncology, as well as the John L. Cameron Chair of Alimentary Tract Diseases and the Chief of the Division of Surgical Oncology until 2016. Dr. Pawlik currently is the Chair of Surgery at The Ohio State University Wexner Medical Center where he holds The Urban Meyer III and Shelley Meyer Chair for Cancer Research. Under his leadership, the Department of Surgery has recruited over 75 new faculty members, is ranked #6 for NIH funding, and has a top 10 ranked surgical residency program. Dr. Pawlik also serves as the Treasurer / Secretary of The Ohio State University Practice Plan. Dr. Pawlik has given over 575 invited talks both nationally and internationally in 35 different countries. Dr. Pawlik has published over 1,600 articles and over 100 book chapters, in addition to editing 14 surgical textbooks. His research has been cited over 72,000 times with an H-index of 128 and an iCite weighted RCR of 2717. Dr. Pawlik serves on multiple editorial boards and is Editor-in-Chief of Journal of Gastrointestinal Surgery, Deputy Editor of JAMA Surgery, as well as an Associate Editor for Annals of Surgical Oncology. Dr. Pawlik has served on the executive council of several of the premier surgical associations in the United States. Dr. Pawlik is a member of multiple surgical societies including the American Surgical Association, Society of Surgical Oncology, Society of Surgery of the Alimentary Tract, Halsted Society, and Society of Clinical Surgery. Dr. Pawlik is a past-President of the Association for Academic Surgery, past-President of the Americas Hepato-Pancreato-Biliary Association, as well as current co-President of the Surgical Biology II Club. Dr. Pawlik’s international contributions have been recognized through his honorary memberships in the Royal Australasian College of Surgeons, Brazilian Society of Surgical Oncology, Mexican Association for Surgery of the Alimentary Tract, Argentinian Hospital de Clinicas, Portugal Surgical Society, as well as the Society of General Surgeons of Perú and the Peruvian International Hepato-Pancreatobiliary Association. Dr. Pawlik is an Associate Member of the Academy of Master Educators in the ACS. Dr. Pawlik’s research focuses on determinations of factors associated with prognosis and staging of gastrointestinal cancers, as well as the economics of cancer care. He also studies patient/physician communication and patient engagement, as well as social determinants of health related to surgery. Dr. Pawlik has consistently been recognized by Castle Connolly as one of America’s “Top Docs.”

Affiliations and expertise

Professor and Chair, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Professor of Surgery, Oncology, and Health Services Management and Policy, Surgeon in Chief, The Ohio State University Wexner Medical Center, Columbus, Ohio

Life sciences

Physical sciences & Engineering

Social sciences & Humanities

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