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Racial and socioeconomic disparities in congenital heart surgery: A research article
Crystal J Richardson1, Priscilla Itua2, Thuy Duong3
1Department of Internal Medicine, Saint James School of Medicine, The Quarter, Anguilla.
Insights
Congenital heart disease (CHD) outcomes are worse for minority infants. Socioeconomic factors and hospital type impact results, highlighting the need for targeted interventions to reduce racial disparities in pediatric heart surgery.
Area of Science:
- Pediatric Cardiology
- Health Disparities Research
- Socioeconomic Determinants of Health
Background:
- Congenital heart disease (CHD) significantly impacts newborns and families globally.
- Minority populations, including Black and Hispanic infants, face disproportionately worse outcomes in CHD care.
- Ethnic disparities in mortality, resource use, and hospital stay duration are evident in pediatric heart surgery.
Purpose of the Study:
- To identify factors contributing to ethnic disparities in congenital heart disease (CHD) outcomes.
- To provide insights for developing targeted interventions for vulnerable minority populations.
- To mitigate adverse outcomes for Black and Hispanic infants undergoing heart surgery.
Main Methods:
- Systematic review of current peer-reviewed literature from major cardiovascular journals and databases.
- Focus on studies concerning CHD, racial disparities, and socioeconomic factors.
- Inclusion criteria: infants without chromosomal anomalies, excluding those deceased before hospital discharge.
Main Results:
- Positive correlations observed between private insurance, maternal education, and favorable post-surgery outcomes.
- Teaching hospitals associated with increased mortality and complications.
- Male infants, Hispanic infants, and Black patients exhibited higher complication and mortality risks.
Conclusions:
- Race significantly influences disparities in congenital heart disease (CHD) care.
- Socioeconomic contributors, surgical practices, and support systems for minority patients require critical evaluation.
- Addressing these disparities through practice changes can improve outcomes for at-risk pediatric populations.
Background:
Though the modern era has proven to be reassuring with the advancement of perioperative care leading to improved survival, congenital heart disease (CHD) continues to underscore its significance in the lives of newborns and families worldwide. Particularly, CHD has disproportionately afflicted vulnerable minorities such as Black and Hispanic populations from the standpoint of ethnic disparities in mortality following heart surgery, increased resource utilization, and longer durations of stay. This study aims to identify and provide insight regarding the relationships between the aforementioned factors to develop targeted strategies of intervention to mitigate the outcomes for patients of these specific populations.
Methods:
Free, current peer-reviewed literature from databases such as the American Heart Association, The European Heart Journal, Science Direct, and PubMed regarding CHD, racial disparities, and socioeconomic variances were accessed. The study was narrowed to a patient population including only infants without chromosomal anomalies or those that passed away before hospital discharge.
Results:
Having private insurance and maternal education showed positive correlations with positive outcomes of patients post congenital heart surgery. Teaching hospitals were linked with increased mortality and complications. Male infants showed higher rates of complications. Hispanics had increased odds of complications. Black patients had increased risk for failures in being rescued.
Conclusions:
Race plays a major role in the disparities in CHD, it is imperative to evaluate the socioeconomic contributors, surgical efforts, and provisions in place regarding minority patients. The apparency of these disparities, and willingness to invoke changes in practice has the potential for improvements in outcomes for these patients.
