Live Event Content · Update Course 2021: DEI – CONCORDANCE AND POST OP COMPLICATION STUDIES
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Video·Published May 2022Older

Update Course 2021: DEI – CONCORDANCE AND POST OP COMPLICATION STUDIES

With Dr. Mira Cogal & Dr. Lee & Dr. Garcia · hosted by Dr. Todd Ponsky
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What the experts said11 expert statements · 7 host summaries
Anchor bias—when an initial diagnostic decision causes subsequent providers to view the patient through that lens—may contribute to delayed diagnosis in patients presenting multiple times with the same complaint.
ClinicalDan
Race is a social construct, not a biological one, challenging historical arguments that genetic factors explain health disparities such as hypertension in African-Americans.
OpinionMeera Kotagal
Gastroschisis mortality is close to zero in the United States due to TPN and NICU resources, but was close to 100% in many resource-limited settings, particularly due to unavailability of TPN and social concerns around the diagnosis.
EpidemiologicalMeera Kotagal
Emergency department literature shows disparities in pain treatment for patients with appendicitis and other conditions, with questions about whether pain is treated equally across patient populations.
ClinicalMeera Kotagal
Maternal mortality between black and white mothers in the United States differs by over 300%, with young black women dying even when they are residents with access to prenatal care at health institutions.
EpidemiologicalLee
Higher infant mortality in black newborns may be a continuation of physiological stress experienced in utero, including higher prematurity rates.
ClinicalLee
Toxic stress and allostatic load have neurobiological mechanisms that contribute to adverse health outcomes, educational attainment, and economic outcomes, with effects beginning in early childhood and even prenatally.
ClinicalGarcia
Pipeline programs to increase diversity must start early—not at the college level—to provide opportunities to underrepresented groups.
OpinionMeera Kotagal
The University of Michigan's cultural complications curriculum provides a framework for surgical departments to discuss cases involving bias and gender schemas in a format similar to morbidity and mortality conferences.
ClinicalMeera Kotagal
Addressing health disparities requires moving beyond hospital walls to tackle social determinants of health and poverty at their roots, not just applying band-aids when patients present for care.
OpinionMeera Kotagal
Community-based interventions must be done in partnership and solidarity with community voices, not in isolation, to understand problems from the community's perspective rather than institutional assumptions.
OpinionMeera Kotagal
African-American children with ASA 1-2 status had over threefold higher 30-day mortality after routine operations compared to other children in the NSQIP database study of 170,000+ children.
Host summaryMeera Kotagal summarizing the discussion · not cited in answers
African-American children with ASA 1-2 status had 18% greater odds of post-operative complications and 7% greater odds of serious adverse events (cardiac arrest, sepsis) after routine operations.
Host summaryMeera Kotagal summarizing the discussion · not cited in answers
Black newborns have a 58% reduction in mortality when treated by black physicians, based on Florida data from 1992-2015 covering 1.8 million births.
Host summaryMeera Kotagal summarizing the discussion · not cited in answers
A highly educated black woman (e.g., a lawyer) has a higher risk of dying in childbirth than a white woman with only a high school education, as demonstrated by Collins from Chicago 20 years ago.
Host summaryGarcia summarizing the discussion · not cited in answers
Michael Marmot's work demonstrated that gainfully employed individuals in the UK National Health System had higher mortality rates the lower they were on the socioeconomic ladder, showing disparities are not unique to racial minorities.
Host summaryGarcia summarizing the discussion · not cited in answers
Racial concordance between physician and newborn affected neonatal mortality but did not impact maternal mortality in the Florida study.
Host summaryMeera Kotagal summarizing the discussion · not cited in answers
Living in the neighborhood around Cincinnati Children's Hospital and not leaving by age 10 has profound negative effects on life expectancy and life trajectory.
Host summaryMeera Kotagal summarizing the discussion · not cited in answers