Applying Interventions to Address the Social Determinants of Health and Reduce Health Disparities in Congenital Heart Disease Patients
Purpose of Review
Congenital heart disease (CHD) is associated with high expenditures, high complications, and the highest hospital readmissions among chronic pediatric diseases. Social determinants of health (SDOH) can further increase the burden of chronic disease on patients and families by reducing access to quality healthcare, safe neighborhoods, and healthy food. Strategies that seek to reduce disparities in the SDOH can have a positive impact on long term outcomes. This is particularly true for CHD patients where more adverse SDOH have been shown to have negative impact on patient outcomes. There is a need to determine if interventions focused on reducing disparities in SDOH utilized in other medical disciplines can be applied to pediatric cardiology. The purpose of our review is to determine how interventions implemented in other medical disciplines may be applied in pediatric cardiology populations to mitigate disparities in the SDOH.
There are community-based participatory research (CBPR) approaches and quality improvement (QI) initiatives that have been used to address disparities in the SDOH. Multi-disciplinary teams that incorporate community partners and have members dedicated to addressing out-of-hospital needs of patients have been trialed and successfully improved patient outcomes. These approaches focus on improving quality of care and mobilizing community resources to minimize access to care barriers. Patient and family empowerment and involvement also play an impactful role to inform research design and health policy questions to work toward promoting research and policies focused on delivering equitable care.
SDOH play a major role in driving health inequities in the CHD population. Adapting interventions effective in mitigating SDOH inequities in other medical disciplines to pediatric cardiology provides the opportunity to improve access of care from the prenatal period through the transition and transfer to adult care and to reduce morbidity and mortality. Examples of intervention adaptations in pediatric cardiology include the following: (1) applying a community-based participatory research approach within interventions to improve detection of CHD and improve perinatal outcomes, (2) developing and applying effective QI initiatives to mitigate disparities throughout the CHD lifespan, (3) meeting access to care needs of CHD patients and families for neurodevelopmental and mental health services, and (4) ensuring quality lifelong care (prenatal to adult congenital) and improving the transition and transfer to adult care.
Curr Cardiovasc Risk Rep
Pediatric cardiology; Congenital Heart Disease; Social determinants of Health; Health Disparities; Interventions
Cherestal, B., Hudson, Z. & Lopez, K.N. Applying Interventions to Address the Social Determinants of Health and Reduce Health Disparities in Congenital Heart Disease Patients. Curr Cardiovasc Risk Rep 16, 241–248 (2022). https://doi.org/10.1007/s12170-022-00710-1