Structural Racism, Social Determinants of Health, and Provider Bias: Impact on Brain Development in Critical Congenital Heart Disease

Jackson, Jamie L.; Grant, Victoria; Barnett, Kierra S; Ball, Molly K.; Khalid, Omar; Texter, Karen; Laney, Brianna; Hoskinson, Kristen R

doi:10.1016/j.cjca.2022.11.001

Cited by 16 publications

(8 citation statements)

References 114 publications

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“…19 SDOH also may have long-term negative effects and impact the development of the brain, immune system, and stress response. [19][20][21] As SDOH contribute to disease mortality and morbidity in the pediatric critical care setting as well as in follow-up care and management of chronic conditions, it is important to understand, identify, and intervene when it occurs. 15,22 SDOH are more frequently screened and addressed in the primary care setting.…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Retrospective Evaluation of Social Determinant of Health Z Code Usage among Pediatric Patients with Critical Care Visits during Pediatric Critical Care

Yoder,

Williams,

Tian

et al. 2023

J Pediatr Intensive Care

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Social determinants of health (SDOH) diagnostic codes may facilitate the deployment of appropriate resources to improve patient outcomes, but their use in critically ill pediatric populations is unknown. Our study aims to examine SDOH codes usage hypothesizing that it is underutilized. This is a retrospective observational cohort study utilizing the TriNetX electronic health record database. We included subjects aged less than 18 years with critical care services billing codes and analyzed demographics, International Classification of Diseases, 10th edition diagnostic codes, and SDOH diagnostic codes 1 year before, during (7 days before and after), and 1 year after critical care services. We included 73,444 subjects (1,150 [1.6%] SDOH codes present during; 1,015 [1.4%] 1 year before; and 1,710 [2.3%] 1 year after critical care services) from 39 health care organizations. The most common SDOH diagnostic code utilized was “problems related to upbringing” (50.4%). SDOH diagnostic codes were consistently significantly associated with diagnostic codes related to seizures. SDOH diagnostic code presence was infrequent in critically ill pediatric patients. These findings may indicate not only the underutilization of SDOH diagnostic code but also the underrepresentation of SDOH prevalence in this patient population.

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Section: Discussionmentioning

confidence: 99%

A Multicenter Retrospective Evaluation of Social Determinant of Health Z Code Usage among Pediatric Patients with Critical Care Visits during Pediatric Critical Care

Yoder,

Williams,

Tian

et al. 2023

J Pediatr Intensive Care

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“…The impact of SDOH on surgical and other early-childhood outcomes in CHD is too broad to adequately cover in this review. It is worth noting that there is extensive research into the disparities that exist in a variety of health outcomes, including surgical mortality, medical complications, and neurodevelopmental outcomes for children living with CHD [27][28][29][30][31][32][33][34]. In a broad systematic review of the literature, SDOHs are found to be "significantly associated with adverse outcomes across the lifespan of CHD patients.…”

Section: Sdoh On Surgical and Other Early Childhood Outcomesmentioning

confidence: 99%

Untangling the Complex Associations between Socioeconomic and Demographic Characteristics and Prenatal Detection and Outcomes in Congenital Heart Disease

Klein,

Donofrio

2024

JCDD

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Recent literature has established a strong foundation examining the associations between socioeconomic/demographic characteristics and outcomes for congenital heart disease. These associations are found beginning in fetal life and influence rates of prenatal detection, access to timely and appropriate delivery room and neonatal interventions, and surgical and other early childhood outcomes. This review takes a broad look at the existing literature and identifies gaps in the current body of research, particularly as it pertains to disparities in the prenatal detection of congenital heart disease within the United States. It also proposes further research and interventions to address these health disparities.

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“…Hasmi, et al [ 40 ], showed a dramatic shift in information processing as pain persists and that emotional circuits become much more activated over time during the pain experience. Other research has also shown us that pain changes the brain, and other social determinants of health can also affect brain development [ 42 , 43 ]. These two findings have had profound implications on PNE.…”

Section: State Of the Artmentioning

confidence: 99%

“…The famous quote of Theodore Roosevelt that addresses this concept is fitting to remember: “No one cares how much you know, until they know how much you care”. Meeting these emotional needs of the patient is grounded in our understanding of the basic science of the shift in brain processing as the pain becomes chronic in the more emotionally related brain areas [ 42 ]. The emotional safety of an individual is built through the reciprocal nature of trust within the healthcare relationship [ 104 , 105 ].…”

Section: Future Directions For Clinical Practicementioning

confidence: 99%

The Biology of Chronic Pain and Its Implications for Pain Neuroscience Education: State of the Art

Zimney

Bogaert

Louw

2023

JCM

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Pain is an individualized experience for the person suffering from chronic pain. Significant strides have been made in the last few decades in understanding various biological changes that coincide with chronic pain. This state-of-the-art overview looks at the current evidence related to the biology of chronic pain and the implications these findings have on the delivery of pain neuroscience education (PNE). The paper summarizes the various (epi)genetic, neural, endocrine, and immune factors discovered and explored in the scientific literature concerning chronic pain. Each of these biological factors has various implications for the content and delivery of PNE. We discuss the future directions these biological factors have for the clinical implementation of PNE by linking the importance of behavior change, optimizing the learning environment, and using an individualized multimodal treatment approach with PNE. In addition, future directions for research of PNE based on these biological factors are provided with importance placed on individualized patient-centered care and how PNE can be used with traditional modes of care and growing trends with other care methods. PNE was originally and continues to be rooted in understanding chronic pain biology and how that understanding can improve patient care and outcomes.

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Structural Racism, Social Determinants of Health, and Provider Bias: Impact on Brain Development in Critical Congenital Heart Disease

Cited by 16 publications

References 114 publications

A Multicenter Retrospective Evaluation of Social Determinant of Health Z Code Usage among Pediatric Patients with Critical Care Visits during Pediatric Critical Care

A Multicenter Retrospective Evaluation of Social Determinant of Health Z Code Usage among Pediatric Patients with Critical Care Visits during Pediatric Critical Care

Untangling the Complex Associations between Socioeconomic and Demographic Characteristics and Prenatal Detection and Outcomes in Congenital Heart Disease

The Biology of Chronic Pain and Its Implications for Pain Neuroscience Education: State of the Art

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