title: Setting a National Agenda for Surgical Disparities Research: Recommendations From the National Institutes of Health and American College of Surgeons Summit.
abstract: Health care disparities (differential access, care, and outcomes owing to factors such as race/ethnicity) are widely established. Compared with other groups, African American individuals have an increased mortality risk across multiple surgical procedures. Gender, sexual orientation, age, and geographic disparities are also well documented. Further research is needed to mitigate these inequities. To do so, the American College of Surgeons and the National Institutes of Health-National Institute of Minority Health and Disparities convened a research summit to develop a national surgical disparities research agenda and funding priorities. Sixty leading researchers and clinicians gathered in May 2015 for a 2-day summit. First, literature on surgical disparities was presented within 5 themes: (1) clinician, (2) patient, (3) systemic/access, (4) clinical quality, and (5) postoperative care and rehabilitation-related factors. These themes were identified via an exhaustive preconference literature review and guided the summit and its interactive consensus-building exercises. After individual thematic presentations, attendees contributed research priorities for each theme. Suggestions were collated, refined, and prioritized during the latter half of the summit. Breakout sessions yielded 3 to 5 top research priorities by theme. Overall priorities, regardless of theme, included improving patient-clinician communication, fostering engagement and community outreach by using technology, improving care at facilities with a higher proportion of minority patients, evaluating the longer-term effect of acute intervention and rehabilitation support, and improving patient centeredness by identifying expectations for recovery. The National Institutes of Health and American College of Surgeons Summit on Surgical Disparities Research succeeded in identifying a comprehensive research agenda. Future research and funding priorities should prioritize patients' care perspectives, workforce diversification and training, and systematic evaluation of health technologies to reduce surgical disparities.
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Adil H
authors.initials: AH
authors.lastname: Haider
authors.affiliation: National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland.
authors.forename: Irene
authors.initials: I
authors.lastname: Dankwa-Mullan
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Allysha C
authors.initials: AC
authors.lastname: Maragh-Bass
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Maya
authors.initials: M
authors.lastname: Torain
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Cheryl K
authors.initials: CK
authors.lastname: Zogg
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Lilley
authors.affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Kodadek
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Navin R
authors.initials: NR
authors.lastname: Changoor
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Peter
authors.initials: P
authors.lastname: Najjar
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: John A
authors.initials: JA
authors.lastname: Rose
authors.affiliation: Department of General Pediatric Surgery, Children's Hospital Los Angeles, University of Southern California, Los Angeles.
authors.forename: Henri R
authors.initials: HR
authors.lastname: Ford
authors.affiliation: Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts2Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.affiliation: Department of Surgery, Albany Medical College, Albany, New York.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Stain
authors.affiliation: Office of Chief Quality Officer, Baylor Scott and White Health System, Dallas, Texas.
authors.forename: Shahid
authors.initials: S
authors.lastname: Shafi
authors.affiliation: Division of General Surgery, United Regional Hospital, Kell West Regional Hospital, Wichita Falls, Texas.
authors.forename: Beth
authors.initials: B
authors.lastname: Sutton
authors.affiliation: American College of Surgeons, Chicago, Illinois.
authors.forename: David
authors.initials: D
authors.lastname: Hoyt
authors.affiliation: National Institutes of Health, Bethesda, Maryland.
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: Maddox
authors.affiliation: Department of Surgery, Eastern Virginia Medical School, Norfolk.
authors.forename: L D
authors.initials: LD
authors.lastname: Britt
mesh_terms: D035843:Biomedical Research; D054521:Cultural Competency; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D009316:National Institutes of Health (U.S.); D010817:Physician-Patient Relations; D011182:Postoperative Care; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D012955:Societies, Medical; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000534:rehabilitation; D014481:United States