Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex; Michael E. DeBakey Veterans Affairs Center, Houston, Tex.
Division of Vascular Surgery and Endovascular Therapy, Department of Cardiovascular and Thoracic Surgery, School of Medicine, West Virginia University, Morgantown, WV; Department of Occupational and Environmental Health Sciences, School of Public Health, West Virginia University, Morgantown, WV.
J Vasc Surg. 2021 Aug;74(2S):6S-14S.e1. doi: 10.1016/j.jvs.2021.03.055.
Health disparities in vascular surgical care have existed for decades. Persons categorized as Black undergo a nearly twofold greater risk-adjusted rate of leg amputations. Persons categorized as Black, Latinx, and women have hemodialysis initiated via autogenous fistula less often than male persons categorized as White. Persons categorized as Black, Latino, Latina, or Latinx, and women are less likely to undergo carotid endarterectomy for symptomatic carotid stenosis and repair of abdominal aortic aneurysms. New approaches are needed to address these disparities. We suggest surgeons use data to identify groups that would most benefit from medical care and then partner with community organizations or individuals to create lasting health benefits. Surgeons alone cannot rectify the structural inequalities present in American society. However, all surgeons should contribute to ensuring that all people have access to high-quality vascular surgical care.
血管外科学医疗服务中的健康差异已经存在了几十年。被归类为黑人的人群接受腿部截肢手术的风险调整后发生率几乎高出两倍。被归类为黑人、拉丁裔和女性的人群接受自体动静脉瘘建立血液透析的比例低于被归类为白人的男性人群。被归类为黑人、拉丁裔、拉丁女性或拉丁男性以及女性的人群接受症状性颈动脉狭窄颈动脉内膜切除术和腹主动脉瘤修复的比例较低。需要采取新方法来解决这些差异。我们建议外科医生使用数据来确定最需要医疗护理的人群,然后与社区组织或个人合作,以带来持久的健康效益。外科医生单枪匹马无法纠正美国社会中存在的结构性不平等。然而,所有外科医生都应该为确保所有人都能获得高质量的血管外科学医疗服务做出贡献。