On a Quest to Combat Surgical Disparities, NIMHD and the American College of Surgeons Hold Symposium

More than 60 researchers, surgeons, scientists and federal leaders convened at the Symposium on Disparities in Surgical Care and Outcomes this spring to assess the current state of the science and develop a research agenda for addressing the disparities in surgical care, outcomes and treatment. The National Institute on Minority Health and Health Disparities (NIMHD) hosted the event with the American College of Surgeons in Bethesda, Maryland, on May 7-8, 2015, at the National Institutes of Health (NIH) campus.

Surgical disparities are considered to be the differences in access to or availability and provision of quality surgical care and outcomes that are experienced by patients of diverse backgrounds. As the field of surgical disparities is relatively sparse, the symposium was the first of its kind to be held at the NIH to address the need for research in this area.

"Health disparities is an issue that NIH takes on, not just NIMHD," said Dr. Yvonne T. Maddox, former acting director, NIMHD. "There are major gaps in the science of surgical disparities, including the unmet needs and impact on health disparities. The need for funding in this area is great, and I would expect several research opportunities to result from the groundwork laid at the symposium."

During the two-day event, attendees heard presentations and panel discussions by leaders in the surgical and health disparities fields including Dr. Jonathan Woodson, assistant secretary of defense for health affairs, Department of Defense; Dr. Nadine Gracia, deputy assistant secretary for Minority Health, Department of Health and Human Services, Dr. Jonca Bull, director, Office of Minority Health, U.S. Food and Drug Administration; and a keynote address by Dr. Atul Gawande, professor of surgery, Harvard Medical School, author and executive director, Ariadne Labs.

It was highlighted during the symposium that only a few hundred publications on surgical disparities exist. Some outcomes from studies have shown that patients of lower socioeconomic status have significantly increased rates of complication, mortality and slower recovery and rehabilitation after major surgery. "There is no quality without access," said Dr. L.D. Britt, chairperson, American College of Surgeons Committee on Optimal Access as he explained ACS's commitment to addressing surgical disparities, which is presented in the organization's November 2010 statement on health care disparities.

Discussion sessions focused on five major crosscutting themes underlying determinants of disparities in surgical outcomes: patient factors, systemic factors and access issues, clinical care and quality, provider factors and post-operative care, and rehabilitation. Building upon these sessions, symposium participants took part in a formal, agenda-setting exercise to develop and refine a set of recommendations on national priorities in surgical disparities research.

The intended outcome for this symposium is to develop a research agenda and strategic plan that includes key recommendations for addressing disparities in surgical care and outcomes.