Last month, the National Institutes of Health (NIH) opened the doors of its campus to more than 60 top-level researchers, surgeon-scientists and federal leaders for the NIH-ACS Symposium on Surgical Disparities Research.
The event was held by the National Institute on Minority Health and Health Disparities (NIMHD) and the American College of Surgeons (ACS), and it was organized and facilitated by the Center for Surgery and Public Health (CSPH) at BWH. It was the culmination of months of planning and preparation, and marked a serious commitment by all groups involved to the topic of surgical disparities research.
“The NIMHD and the ACS have been interested in collaborating around this topic for years,” said Adil Haider, MD, MPH, Kessler director of the CSPH and vice chair of the ACS’s Committee on Optimal Access. “I was thrilled that the CSPH could serve as a vehicle for bringing that collaboration to fruition, and that the symposium could act as a conduit for channeling the existing interest from both groups.”
The term surgical disparities describes the differences in access to or availability and provision of quality surgical care and outcomes that are experienced by patients of diverse backgrounds, taking into consideration factors such as socioeconomic status, age, gender, level of education, race, ethnicity and location of residence. Some outcomes studies have shown that patients of lower socioeconomic status have significantly increased rates of complication, mortality and failure to rescue after major surgery, and that there’s a 50 percent increase in the odds of death for patients without health insurance. Findings such as these have led the ACS to create the Committee on Optimal Access and to release a statement explaining the connection between access to care and disparate outcomes. According to the statement, “optimal access is the key to quality of care.”
“I have long said that there can be no quality without access,” said L.D. Britt, MD, MPH, FACS, chair of the Committee on Optimal Access and a professor at Eastern Virginia Medical School. Britt played a critical role in the creation of the committee, and defined the committee’s deliverables, which included a national symposium.
The field of surgical disparities is important, but also relatively new. Only a few hundred publications on the topic exist, and they have been compiled in a searchable online database. The symposium was the first of its kind to be held at the NIH, created to address the dire need for research in this area.
“There are major gaps in the science of surgical disparities, the unmet needs and impact on health disparities,” said Yvonne Maddox, PhD, acting director of the NIMHD. “The need for funding in this area is great, and I would expect several research opportunities to result from the groundwork that was laid at the symposium.”
During the two-day event, attendees heard keynote presentations by Atul Gawande, MD, MPH, noted surgeon, writer, executive director of Ariadne Labs and former director of CSPH, and Jonathan Woodson, MD, assistant secretary of defense for health affairs. There were also several thematic presentations made by surgeons and outside experts that summed up highlights in surgical disparities research to date, followed by discussion from a panel of respected federal stakeholders.
“I’ve heard nothing but positive feedback from our speakers, attendees and colleagues at the NIH and the ACS,” said Haider. “We successfully created a national research agenda that can be used moving forward, although it’s clear that our job isn’t done. We hope that this is just the beginning of a conversation, and that the NIH and the ACS will continue to work together to establish a funding stream to support this important research and foster systemic change, effectively eliminating surgical and other healthcare disparities.”