Racial and Socioeconomic Disparities After Surgical Resection for Rectal Cancer

Patient Social Vulnerability and Hospital Community Racial/Ethnic Integration: Do All Patients Undergoing Pancreatectomy Receive the Same Care Across Hospitals?

“…Previous researchers have attempted to assess how SDH may be linked to access to care or, in some instances, higher quality care such as high-volume hospitals or designated cancer centers. [34][35][36][37][38] The majority of these studies have, however, considered only patient-level factors to include factors that characterize the communities in which patients live and have not considered how hospital community-level factors may play a role in the quality of care delivered to patients. As such, by combining both patientlevel SVI and hospital-level REI, this study utilized a novel approach to examine how SDH might be associated with postoperative outcomes after pancreatectomy.…”

“…Part of these efforts has focused on the identification of factors associated with variations in postoperative outcomes, including race/ethnicity, sex, age, and surrogates for SES. Previous researchers have attempted to assess how SDH may be linked to access to care or, in some instances, higher quality care such as high-volume hospitals or designated cancer centers 34–38 . The majority of these studies have, however, considered only patient-level factors to include factors that characterize the communities in which patients live and have not considered how hospital community-level factors may play a role in the quality of care delivered to patients.…”

Racial Disparities in Colorectal Cancer Care for Black Patients: Barriers and Solutions

“…Insurance status remains a critically important factor in disease outcomes as poor insurance status has been shown to be independently associated with lower overall and disease-specific survival, lower rates of minimally invasive surgery, and greater rates of postoperative complications. 1,23 Insurance status has been posited to be a partial mediator of the racial disparities in colorectal cancer diagnosis and treatment among Black patients, particularly due to the finding that Black patients are more likely to be uninsured or underinsured compared to White patients. 24 There are systemic issues that have led in part to this disparity; for example, Black patients and other minorities in general are underrepresented in high-paying jobs that provide health insurance in a benefits package.…”

“…For colorectal cancer, access to high-volume hospitals have been associated with improved outcomes, including decreased length of stay, lower hospital charges, and decreased postoperative complications. 1,23 However, Black patients are more often treated at lower volume centers, which translates to surgery by lower volume surgeons and higher mortality rates. [44][45][46] Interestingly, this decreased utilization of high-volume centers is not related to physical proximity or distance traveled.…”

“…Notably, Black patients have been found to have a nearly 10% poorer median survival difference when compared to White patients. 1 Although oncologic advances have improved the overall outcomes for all colorectal cancer patients with the turn of the 21st century, as of the late 2000s, the racial disparity gap in mortality between Black and White patients has not changed. [2][3][4][5] There are multiple interrelated factors that have been implicated along the continuum of colorectal cancer care, from diagnosis to treatment and surveillance, and range from individual provider implicit bias to systemic socioeconomic factors.…”