Healthcare disparities in vascular surgery: A critical review

Area of Science:

• Vascular Surgery
• Health Equity
• Socioeconomic Determinants of Health

Background:

• Persistent health disparities in vascular surgical care have been documented for decades.
• Significant inequities exist for Black individuals, Latinx individuals, and women regarding access to and outcomes of vascular surgical procedures.
• Existing disparities include higher rates of leg amputations and lower rates of autogenous fistula creation for hemodialysis.

Purpose of the Study:

• To highlight ongoing health disparities in vascular surgical care.
• To underscore the need for novel strategies to mitigate these inequities.
• To advocate for a data-driven, community-engaged approach to improve vascular health outcomes for underserved populations.

Main Methods:

• Review of existing literature and data on disparities in vascular surgical care.
• Identification of specific procedures and patient groups affected by these disparities.
• Proposal of a collaborative model involving surgeons, community organizations, and individuals.

Main Results:

• Black individuals face nearly double the risk-adjusted rate of leg amputations.
• Black, Latinx, and women patients are less likely to receive hemodialysis via autogenous fistula compared to White men.
• Black, Latinx, and women patients are less likely to undergo carotid endarterectomy or abdominal aortic aneurysm repair.

Conclusions:

• Structural inequalities contribute significantly to health disparities in vascular surgery.
• Surgeons must leverage data to identify at-risk populations and collaborate with community partners.
• A collective effort is essential to ensure equitable access to high-quality vascular surgical care for all individuals.