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Intersection of Disparities and Social Determinants of Health.
1Department of Surgery, University of Louisville, Louisville, KY, USA; Norton Children's Hospital, Division of Pediatric Surgery, Louisville, KY, USA; Pediatric Research Institute, Department of Pediatrics, University of Louisville, Louisville, KY, USA.
The Surgical Clinics of North America
|June 1, 2026
Summary
Social determinants of health (SDOH) worsen surgical care disparities. Understanding economic stability, education, healthcare access, environment, and social context is key to addressing these inequities.
Area of Science:
- Surgical outcomes research
- Health equity studies
- Social determinants of health (SDOH) analysis
Background:
- Social determinants of health (SDOH) significantly impact surgical patient access, treatment outcomes, and recovery.
- Structural inequities exacerbate health disparities within the surgical care continuum.
- Existing research often overlooks the interconnectedness of SDOH domains in shaping surgical health inequities.
Purpose of the Study:
- To elucidate the complex interplay between the 5 domains of SDOH and disparities in surgical care.
- To synthesize evidence linking specific social conditions to differential surgical outcomes.
- To highlight how structural factors influence patient access to and results from surgical interventions.
Main Methods:
- Systematic review of evidence linking SDOH to surgical disparities.
- Analysis of the 5 key SDOH domains: economic stability, education, healthcare access, neighborhood environment, and social context.
- Qualitative synthesis of research illustrating mechanisms of influence.
Main Results:
- Economic instability is linked to reduced surgical access and poorer recovery.
- Educational disparities correlate with lower health literacy and worse surgical outcomes.
- Unequal healthcare access and quality disproportionately affect surgical treatment and results.
- Neighborhood and built environment factors influence pre- and post-operative care.
- Social and community context plays a critical role in patient support and surgical recovery.
Conclusions:
- Addressing SDOH is crucial for mitigating disparities in surgical care.
- Interventions must target the structural determinants of health to improve surgical equity.
- A comprehensive approach integrating social factors is necessary for equitable surgical outcomes.
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