Akbilgic Oguz, Shin Eun Kyong, Shaban-Nejad Arash
Department of Health Informatics and Data Science, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, IL, United States.
Department of Sociology, Korea University, Seoul, South Korea.
Front Pediatr. 2021 Mar 12;9:620848. doi: 10.3389/fped.2021.620848. eCollection 2021.
Scientific evidence confirm that significant racial disparities exist in healthcare, including surgery outcomes. However, the causal pathway underlying disparities at preoperative physical condition of children is not well-understood. This research aims to uncover the role of socioeconomic and environmental factors in racial disparities at the preoperative physical condition of children through multidimensional integration of several data sources at the patient and population level. After the data integration process an unsupervised k-means algorithm on neighborhood quality metrics was developed to split 29 zip-codes from Memphis, TN into good and poor-quality neighborhoods. An unadjusted comparison of African Americans and white children showed that the prevalence of poor preoperative condition is significantly higher among African Americans compared to whites. No statistically significant difference in surgery outcome was present when adjusted by surgical severity and neighborhood quality. The socioenvironmental factors affect the preoperative clinical condition of children and their surgical outcomes.
科学证据证实,医疗保健领域存在显著的种族差异,包括手术结果。然而,儿童术前身体状况差异背后的因果路径尚未得到充分理解。本研究旨在通过在患者和人群层面多维整合多个数据源,揭示社会经济和环境因素在儿童术前身体状况种族差异中的作用。在数据整合过程之后,开发了一种基于社区质量指标的无监督k均值算法,将田纳西州孟菲斯市的29个邮政编码区域划分为优质和劣质社区。对非裔美国儿童和白人儿童的未经调整比较显示,与白人相比,非裔美国儿童术前身体状况不佳的患病率显著更高。在根据手术严重程度和社区质量进行调整后,手术结果没有统计学上的显著差异。社会环境因素会影响儿童的术前临床状况及其手术结果。