Novel Characterization of Socioecological Determinants of Health in Rural Alabama

Details

• Alternative Title:
  J Surg Res
• Personal Author:
  English, Nathan C. ; Smith, Burkely P. ; Jones, Bayley A. ; Oslock, Wendelyn ; Hollis, Robert H. ; Wood, Lauren ; Rubyan, Michael ; Kennedy, Gregory ; Kaushik, Manu ; Gibson, Quince-Xhosa ; Swenson, Lacey ; Chu, Daniel I.
• Description:
  Background
  
  Socioecological determinants of health (SEDOHs) influence disparities in surgical outcomes. However, SEDOHs are challenging to measure limiting our ability to address disparities. Using a validated survey (SEDOH-88), we assessed SEDOHs in three rural communities in Alabama. We hypothesized that SEDOHs would vary significantly across sites but measuring them would be acceptable/feasible.
  
  Materials and methods
  
  This was a retrospective review of a prospectively maintained database involving surgical patients who completed the SEDOH-88 and a secondary survey assessing it’s acceptability/feasibility, from August 2021 to July 2023. Included patients underwent endoscopic, minimally invasive, or open surgery at three rural hospitals: Demopolis (DM), Alexander City (AC), and Greenville (GV).
  
  Results
  
  The 107 participants comprised 48 (44.9%) from DM, 27 (25.2%) from AC, and 32 (29.9%) from GV, respectively. The median age was 64-years and 65.6% were female. When comparing DM to AC and GV by individual factors, DM had the largest Black population (78.7 vs. 22.2 vs. 48.3%, p<0.001), and more often required help reading hospital materials (20.5 vs. 3.7 vs. 10.3%, p=0.007). When comparing DM to AC and GV by structural and environmental factors, DM had more Medicaid enrollees (27.3 vs. 3.7 vs. 6.9%, p=0.033), and lacked fresh produce (18.2 vs. 25.9 vs. 39.3%, p=0.033) and internet access (63.6 vs. 100.0 vs. 86.2%, p<0.001). The SEDOH-88 had an overall 90.9% positive acceptability/feasibility score.
  
  Conclusion
  
  SEDOHs varied significantly across rural communities regarding individual (race/health literacy), structural (insurance), and environmental-level factors (nutritious food/internet access). The high acceptability/feasibility of the SEDOH-88 shows it’s potential utility in identifying targets for future disparity-reducing interventions.
  
  
• Subjects:
  Adult Aged Alabama Feasibility Studies Female Healthcare Disparities Humans Male Middle Aged Retrospective Studies Rural Population Social Determinants Of Health Surveys And Questionnaires

  More +
• Keywords:
  Rural Socioecological Surgical Disparities
• Source:
  J Surg Res. 301:468-481
• Pubmed ID:
  39033598
• Pubmed Central ID:
  PMC11427147
• Document Type:
  Journal Article
• Funding:
  U01 DP006746/DP/NCCDPHP CDC HHSUnited States/ ; R01 CA271303/CA/NCI NIH HHSUnited States/ ; K12 HS023009/HS/AHRQ HHSUnited States/ ; K23 MD013903/MD/NIMHD NIH HHSUnited States/ ; R01 MD013858/MD/NIMHD NIH HHSUnited States/
• Volume:
  301
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c2f4e9a1ac87aa08d4bd965e8815f874829e4a395f667d6e28fe9b70876ae474c00b98c533421545bfca5570f4544681a95d21eed089c3ac865ee98a89abeda9
• Download URL:
  https://stacks.cdc.gov/view/cdc/164030/cdc_164030_DS1.pdf
• File Type:
  [PDF - 901.75 KB ]