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Asfaw ZK, Germano IM. In Reply: Racial and Ethnical Diversity Within the Neurosurgery Resident and Faculty Workforce in the United States. Neurosurgery 2024; 95:e107. [PMID: 38953648 DOI: 10.1227/neu.0000000000003101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 07/04/2024] Open
Affiliation(s)
- Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York , New York , USA
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Foresi B, Zoeller G, Pannullo S. Letter: Racial and Ethnical Diversity Within the Neurosurgery Resident and Faculty Workforce in the United States. Neurosurgery 2024; 95:e105-e106. [PMID: 38953647 DOI: 10.1227/neu.0000000000003100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 07/04/2024] Open
Affiliation(s)
- Brian Foresi
- College of Medicine, Northeast Ohio Medical University, Rootstown , Ohio , USA
| | - Garrett Zoeller
- Department of Neurosurgery, Oregon Health & Science University, Portland , Oregon , USA
- Department of Pediatric Neurosurgery, Randall Children's Hospital, Portland , Oregon , USA
| | - Susan Pannullo
- Department of Neurosurgery, New York Presbyterian/Weill Cornell, New York , New York , USA
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Foresi B, Galbraith L, Uzoukwu C, Ezeudu C, Najafali D, Pannullo S. Assessment of LGBTQ+ Diversity, Equity, and Inclusion in Subspecialty Surgery Literature: A Scoping Review. World Neurosurg 2024; 190:297-307. [PMID: 39059720 DOI: 10.1016/j.wneu.2024.07.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE To identify LGBTQ+ diversity, equity, and inclusion (DEI) publications and contextualize the current frequency of the literature across subspecialty surgical fields. METHODS A PRISMA systematic review using PubMed, MEDLINE, and Web of Science was conducted in April 2024. The main inclusion criterion was intrafield DEI content for defined subspecialties; exclusion criteria were foreign language, poor methodology, and duplicates. The primary endpoint was the number of publications across subspecialties. Secondary endpoints included publication dates, study design, and sample size. RESULTS Of the 702 articles identified, 27 were included in the analysis. Neurologic surgery had 2 studies; plastic surgery, 11 studies; orthopedic surgery, 7 studies; otolaryngology, 5 studies; and thoracic surgery, 2 studies. There was a statistically significant different frequency of publications across subspecialties (P = 0.031). Post hoc residual analysis indicated that neurosurgery and thoracic surgery had statistically fewer publications, while plastic surgery had statistically more publications (P = 0.04, 0.002, 0.21, 0.42, and 0.04 for neurologic surgery, plastic surgery, orthopedic surgery, otolaryngology, and thoracic surgery, respectively). Secondary outcomes found a majority of publications between 2022 and 2024. Study methodologies involved cross-sectional studies, editorials, and retrospective reviews (14, 11, and 3 respectively) and had a median sample size of 248.5. CONCLUSIONS This systematic review provides objective data to contextualize DEI literature across surgical subspecialties. Overall, this review highlights the lack of LGBTQ+ DEI literature in neurosurgery and advocates for correcting this gap for the benefit of both surgeons and patients. Understanding the current numbers and evaluating progress in other surgical fields might provide solutions.
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Affiliation(s)
- Brian Foresi
- Northeast Ohio Medical University, College of Medicine, Rootstown, Ohio, USA.
| | - Logan Galbraith
- Northeast Ohio Medical University, College of Medicine, Rootstown, Ohio, USA
| | - Cynthia Uzoukwu
- Northeast Ohio Medical University, College of Medicine, Rootstown, Ohio, USA
| | | | - Daniel Najafali
- Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - Susan Pannullo
- New York Presbyterian/Weill Cornell, Department of Neurosurgery, New York, New York, USA
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Smith TZ, DeYoung JK, Pum JM, Zurakowski D, Templeton K, Day CS. Odds of Attaining Orthopaedic Leadership Based on Race, Ethnicity, and Sex. J Am Acad Orthop Surg 2024:00124635-990000000-01040. [PMID: 39018573 DOI: 10.5435/jaaos-d-24-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/23/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Despite widespread acceptance of the importance of diversity in leadership, systemic challenges in leadership attainment in orthopaedic surgery still exist for several groups. We hypothesize that women, underrepresented in medicine groups, and Asians have decreased odds of achieving program director and chairperson positions compared with peers. METHODS Demographic data were collected from the Association of American Medical Colleges for faculty, program directors, and chairpersons in orthopaedic surgery. Odds ratios were calculated treating race, ethnicity, or sex as the predictor variables and attainment of a leadership position as the outcome, comparing the composition of program directors in 2020 and chairpersons in 2019 with faculty in 2019. RESULTS Significantly decreased odds were found for women at 0.37 (0.264 to 0.51 [P < 0.0001]) and the Other category at 0.16 (0.065 to 0.3864 [P = 0.0001]) while significantly increased odds were found for White and Black/African American faculty at 1.32 (1.02 to 1.71 [P = 0.0314]) and 1.95 (1.17 to 3.26 [P = 0.011]), respectively, in holding program director positions. Significantly decreased odds of attaining chairpersonship were found for women at 0.17 (0.07 to 0.41 [P = 0.0075]) and Asian faculty at 0.33 (0.14 to 0.75 [P = 0.0062]) while White faculty demonstrated significantly increased odds at 2.43 (1.41 to 4.19 [P = 0.0013]). CONCLUSIONS Women showed markedly decreased odds of leadership attainment while Black/African American faculty had increased likelihood of becoming program directors but were not markedly more likely to become chairs. Asian faculty were less likely to become program directors and markedly less likely to become chairs. While decreased odds for women were expected based on current literature, decreased odds of Asians becoming chairs and an increased likelihood of Black/African American orthopaedic surgeons becoming program directors but not attaining the role of chairs at the same rate were novel findings, revealing concerning trends for these groups.
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Affiliation(s)
- Tobin Z Smith
- From the Wayne State University School of Medicine, Detroit, MI (Smith, DeYoung, and Pum), Departments of Anesthesiology and Surgery, Boston Children's Hospital, Boston, MA (Zurakowski), Harvard Medical School, Cambridge, MA (Zurakowski), Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS (Templeton), Department of Orthopedic Surgery at Henry Ford Health, Wayne State University School of Medicine, Detroit, MI (Day), Michigan State University College of Human Medicine, East Lansing, MI (Day)
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Bishay AE, Hughes NC, Zargari M, Paulo DL, Bishay S, Lyons AT, Morkos MN, Ball TJ, Englot DJ, Bick SK. Disparities in Access to Deep Brain Stimulation for Parkinson's Disease and Proposed Interventions: A Literature Review. Stereotact Funct Neurosurg 2024; 102:179-194. [PMID: 38697047 DOI: 10.1159/000538748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/28/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease (PD), but disparities exist in access to DBS along gender, racial, and socioeconomic lines. SUMMARY Women are underrepresented in clinical trials and less likely to undergo DBS compared to their male counterparts. Racial and ethnic minorities are also less likely to undergo DBS procedures, even when controlling for disease severity and other demographic factors. These disparities can have significant impacts on patients' access to care, quality of life, and ability to manage their debilitating movement disorders. KEY MESSAGES Addressing these disparities requires increasing patient awareness and education, minimizing barriers to equitable access, and implementing diversity and inclusion initiatives within the healthcare system. In this systematic review, we first review literature discussing gender, racial, and socioeconomic disparities in DBS access and then propose several patient, provider, community, and national-level interventions to improve DBS access for all populations.
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Affiliation(s)
- Anthony E Bishay
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA,
| | - Natasha C Hughes
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Michael Zargari
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Danika L Paulo
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Steven Bishay
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Mariam N Morkos
- Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | - Tyler J Ball
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Sarah K Bick
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Wang A, Holly LT. Racial and Ethnic Diversity in Neurosurgery: Challenges, Progress, and Future Directions. Neurosurgery 2024; 94:643-647. [PMID: 38497806 DOI: 10.1227/neu.0000000000002738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 03/19/2024] Open
Affiliation(s)
- Andrew Wang
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Langston T Holly
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA
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Pierre K, Bardhi O, Laurent D, Vaziri S, Lucke-Wold B, Brennan MM, Dagra A, Olowofela B, Barthélemy E. The AANS Harvey Cushing Medal: a demographic and academic analysis of its recipients. EGYPTIAN JOURNAL OF NEUROSURGERY 2023; 38:66. [PMID: 38037602 PMCID: PMC10688272 DOI: 10.1186/s41984-023-00243-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/28/2023] [Indexed: 12/02/2023] Open
Abstract
Background The Harvey Cushing Medal, awarded by the American Association of Neurological Surgeons, is the premier accolade in neurosurgery. The study's purpose was to examine the qualities and accomplishments of previous winners, emphasizing potential selection biases, with the aim to promote social justice and guide young neurosurgeons in their career paths. Results Predominantly, recipients graduated from top-ranked United States News and World Report institutions and specialized in cerebrovascular and neuro-oncologic/skull base neurosurgery. A significant proportion held roles as department or division chairs and led neurosurgical organizations. All awardees were male, and there was a notable trend of increasing publication counts among more recent recipients. Conclusions Commonalities among Harvey Cushing Medal winners include graduating from top institutions, holding significant leadership roles, and having an extensive publication history. However, the absence of female and underrepresented minority awardees underscores an urgent need for greater diversity in the selection process.
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Affiliation(s)
- Kevin Pierre
- Department of Radiology, University of Florida, 1600 SW Archer Rd, PO Box 100265, Gainesville, FL 32610-0265, USA
| | - Olgert Bardhi
- Department of Medicine, University of Texas Southwestern, Dallas, TX, USA
| | - Dimitri Laurent
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Sasha Vaziri
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | | | - Meghan M. Brennan
- Department of Anesthesiology, University of Florida, Gainesville, FL, USA
| | - Abeer Dagra
- College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Ernest Barthélemy
- Division of Neurosurgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Saeed F, Ilic T, Haq M, Sarmath G, Syrmos N, Alalade AF, Hernández-Durán S. Representation of minorities in European neurosurgical leadership. BRAIN & SPINE 2023; 3:101788. [PMID: 38021028 PMCID: PMC10668052 DOI: 10.1016/j.bas.2023.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/25/2023] [Indexed: 12/01/2023]
Abstract
Introduction Ethnic diversity has significantly increased within European countries since World War II for several reasons. However, there continues to be a contrasting lag in leadership positions within healthcare circles, and neurosurgery is no exception. Under-representation of minorities is a contributory factor to recurring problems of healthcare inequality. Research question The European Association of Neurosurgical Societies (EANS) Diversity Committee (DC) set out to examine trends in underrepresented minority (URM) representation in leadership positions across Europe. Material and methods Data on the race and ethnicity of departmental heads across the units in the European nations was collated. We defined the term 'ethnic minority' in line with the criteria set by the European Commission against Racism and Intolerance (ECRI). The percentage of URM among the European neurosurgical units was analysed against the demographics of the respective countries to assess whether there was a corresponding association. Results The percentage of URM representation was low across most European countries. Countries with the highest immigration rates e.g. Great Britain and Germany had the highest rates of representation within the neurosurgical leadership in comparison to other countries. The Balkan states had zero rates of URM representation within the neurosurgical leadership. Discussion and conclusion Our findings demonstrate that URM representation in neurosurgical leadership across European countries is significantly low. Selection policies, training curricula and recruitment processes aimed at improving health inequality are necessary. Further studies are needed to elucidate the factors contributing to the low participation of URM in neurosurgical leadership.
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Affiliation(s)
- Fozia Saeed
- Department of Neurosurgery, Leeds General Infirmary, Leeds, LS1 3EX, United Kingdom
| | - Tijana Ilic
- National Department of Neurosurgery, Center Hospitalier de Luxembourg, Luxembourg
| | - Makinah Haq
- King's College London, Strand Campus, Strand, London, WC2R 2LS, United Kingdom
| | - Gargi Sarmath
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, United Kingdom
| | - Nikolaos Syrmos
- Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Andrew F. Alalade
- Department of Neurosurgery, Royal Preston Hospital, Preston, PR2 9HT, United Kingdom
| | | | - for the European Association of Neurosurgical Societies (EANS) Diversity Committee
- Department of Neurosurgery, Leeds General Infirmary, Leeds, LS1 3EX, United Kingdom
- National Department of Neurosurgery, Center Hospitalier de Luxembourg, Luxembourg
- King's College London, Strand Campus, Strand, London, WC2R 2LS, United Kingdom
- Department of Surgery, University Hospital Southampton NHS Foundation Trust, United Kingdom
- Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
- Department of Neurosurgery, Royal Preston Hospital, Preston, PR2 9HT, United Kingdom
- Department of Neurosurgery, Gottingen University Hospital, Gottingen, Germany
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McNeill IT, Carrasquilla A, Asfaw ZK, Barthélemy EJ, Mehr A, Townsend KD, Joseph A, Bederson JB, Butts GC, Germano IM. Breaking boundaries through Doctors Reaching Minority Men Exploring Neuroscience: a mentorship model to foster a pipeline for underrepresented minorities. J Neurosurg 2023; 138:533-539. [PMID: 35901743 DOI: 10.3171/2022.5.jns22196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/04/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE In 2015, the Association of American Medical Colleges report titled "Altering the Course: Black Males in Medicine" showed a decline in the number of Black men matriculating into medical school. To alter this trend, the authors' hypothesis was that formally exposing Black men to the clinical neurosciences during high school would enhance their chances of entering the physician workforce. For this reason, in 2007, the Doctors Reaching Minority Men Exploring Neuroscience (DR. MMEN) program was established at the Icahn School of Medicine at Mount Sinai. The program aimed to provide early exposure, mentorship, and inspiration to high school-age Black and Latinx men. The aim of this study was to evaluate the impact of the DR. MMEN program in the context of the recent race and ethnicity trends among medical school matriculants (MSMs). METHODS Association of American Medical Colleges data on MSMs stratified by race and ethnicity were reviewed for the period between 2015 and 2020. Data pertinent to the academic achievements of DR. MMEN participants, such as matriculation to college and/or medical school, were prospectively tracked and incorporated with mixed-methods exit assessment data. Qualitative responses were coded and analyzed using a thematic concept analysis method. RESULTS Over the study period, the increase of MSMs in the US was 1.0% and 1.7% for Black and Latinx individuals, respectively. Changes for the male MSM cohort were negligible: 0.3% for Black and 0.7% for Latinx. With respect to DR. MMEN, 42% of participants from 2017 to 2019 earned college scholarships, and 25% of students from the 2017-2018 cohort matriculated to a combined college-medical program. Survey data showed that 100% of DR. MMEN participants found the program useful. Analysis of qualitative data revealed that participants considered pursuing a career in neurosurgery or in another medical field. Diligence and a passion for medicine were identified as the top two most important lessons in the program, and witnessing patient satisfaction and observing a neurosurgery operation were described as the most important experiences. Participants considered availability to give advice and feedback and a passion for teaching as the principal attributes of their mentors. CONCLUSIONS Over the past 6 years, the slight increase in Black and Latinx MSMs has not been significant enough to remedy ethnoracial disparities among MSMs. In particular, Black male matriculation to medical school has remained stagnant. The DR. MMEN program is a promising model to inspire young scholars and improve diversity within neuroscience and medicine at large.
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Affiliation(s)
- Ian T McNeill
- 1Division of Neurosurgery, Department of Surgery, University of Connecticut, Farmington, Connecticut
| | - Alejandro Carrasquilla
- 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zerubabbel K Asfaw
- 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ernest J Barthélemy
- 3Department of Neurological Surgery, University of California, San Francisco, California; and
| | - Alyson Mehr
- 4Office for Diversity and Inclusion, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kenya D Townsend
- 4Office for Diversity and Inclusion, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander Joseph
- 4Office for Diversity and Inclusion, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua B Bederson
- 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Gary C Butts
- 4Office for Diversity and Inclusion, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Isabelle M Germano
- 2Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
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Asfaw ZK, Rodriguez A, Hodges TR, Mazumdar M, Zhan S, Lim M, Germano IM. Diversity within the neurosurgical oncology workforce in the United States: A cross-sectional study with proposed strategies to pave the path forward. Neuro Oncol 2022; 25:177-184. [PMID: 35705107 PMCID: PMC9825340 DOI: 10.1093/neuonc/noac150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Improving and fostering diversity within the neurosurgical workforce has become a high priority. This cross-sectional study aims to provide data on the diversity of neurosurgical oncology faculty (NSOF) in the US. METHODS All 115 neurosurgery (NS) Accreditation Council for Graduate Medical Education (ACGME) accredited programs were included in this study. The academic rank, academic and clinical title(s), gender, race, and hiring date of neurosurgical faculty with a primary focus on neurosurgical oncology (NSOF) were recorded. Geographical distribution and "top 10" programs were tabulated according to published data. Underrepresented minorities in medicine (URiM) faculty were identified according to the AAMC definition. RESULTS The NSOF workforce constitutes 21% of the total NS faculty. Of these, 10.1% are women and 9.9% are URiM (P < .001). Currently, 58% of neurosurgery programs (NSP) do not have URiM and/or women NSOF. The top 10 ranked NSP, according to Blue Ridge Institute for Medical Research, had a significantly less URiM NSOF (P = .019) than nontop 10 ranked programs. There was a decreasing trend in the proportion of URiM at higher academic ranks (P = .019). All of the URiM department chairs (3/113)-all men-and 1/3 women department chairs nationwide subspecialized in neurosurgical oncology. CONCLUSIONS Neurosurgical oncology is a sought-after subspecialty attracting a fifth of neurosurgeons practicing in ACGME-accredited training programs. Changing demographics and the benefits of workforce diversity represent a great opportunity for our field to continue leading inclusion efforts and attracting the best and brightest.
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Affiliation(s)
- Zerubabbel Ketema Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Analiz Rodriguez
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arizona, USA
| | - Tiffany Renee Hodges
- Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Madhu Mazumdar
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Serena Zhan
- Department of Population Health Science and Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael Lim
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Isabelle Margherita Germano
- Corresponding Author: Isabelle M. Germano, MD, MBA, FACS, Department of Neurosurgery, Icahn School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA ()
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Barthélemy EJ, Affana CK, Asfaw ZK, Dams-O'Connor K, Rahman J, Jones S, Ullman J, Margetis K, Hickman ZL, Dangayach NS, Giwa AO. Racial and Socioeconomic Disparities in Neurotrauma: Research Priorities in the New York Metropolitan Area through a Global Neurosurgery Paradigm. World Neurosurg 2022; 165:51-57. [PMID: 35700861 DOI: 10.1016/j.wneu.2022.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
The New York Neurotrauma Consortium (NYNC) is a nascent multidisciplinary research and advocacy organization based in the New York Metropolitan Area (NYMA). It aims to advance health equity and optimize outcomes for traumatic brain and spine injury patients. Given the extensive racial, ethnic, and socioeconomic diversity of the NYMA, global health frameworks aimed at eliminating disparities in neurotrauma may provide a relevant and useful model for the informing research agendas of consortia like the NYNC. In this review, we present a comparative analysis of key health disparities in traumatic brain injury (TBI) that persist in the NYMA as well as in low- and middle-income countries (LMIC). Examples include: (a) inequitable access to quality care due to fragmentation of healthcare systems, (b) barriers to effective prehospital care for TBI, and (c) socioeconomic challenges faced by patients and their families during the subacute and chronic post-injury phases of TBI care. This review presents strategies to address each area of health disparity based on previous studies conducted in both LMIC and high-income country (HIC) settings. Increased awareness of healthcare disparities, education of healthcare professionals, effective policy advocacy for systemic changes, and fostering racial diversity of the trauma care workforce can guide the development of trauma care systems in the NYMA that are free of racial and related healthcare disparities.
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Affiliation(s)
- Ernest J Barthélemy
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA; Center for Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, California, USA.
| | | | - Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
| | - Kristen Dams-O'Connor
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jueria Rahman
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York
| | - Salazar Jones
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York
| | - Jamie Ullman
- New York Neurotrauma Consortium, Inc., New York, New York; Institute for Neurology and Neurosurgery at North Shore University Hospital
| | - Konstantinos Margetis
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
| | - Zachary L Hickman
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York
| | - Neha S Dangayach
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Al O Giwa
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Schill C, Cedeño F, Rabin D. What's new in academic international medicine? Improving the state of representation in the neurosurgical workforce. INTERNATIONAL JOURNAL OF ACADEMIC MEDICINE 2022. [DOI: 10.4103/ijam.ijam_106_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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