RESUMEN
Despite significant advances in health care, many patients from medically under-served populations are impacted by existing health care disparities. Radiologists are uniquely positioned to decrease health disparities and advance health equity efforts in their practices. However, literature on practical tools for advancing radiology health equity efforts applicable to a wide variety of patient populations and care settings is lacking. Therefore, this article seeks to equip radiologists with an evidence-based and practical knowledge tool kit of health equity strategies, presented in terms of four pillars of research, clinical care, education, and innovation. For each pillar, equity efforts across diverse patient populations and radiology practice settings are examined through the lens of existing barriers, current best practices, and future directions, incorporating practical examples relevant to a spectrum of patient populations. Health equity efforts provide an opportune window to transform radiology through personalized care delivery that is responsive to diverse patient needs. Guided by compassion and empathy as core principles of health equity, the four pillars provide a helpful framework to advance health equity efforts as a step toward social justice in health.
Asunto(s)
Equidad en Salud , Radiología , Humanos , Disparidades en Atención de Salud , Justicia SocialRESUMEN
Initial studies suggest that women living in U.S. territories may experience barriers to appropriate breast cancer diagnosis and treatment. Our purpose was to evaluate mammography screening engagement in U.S. territories compared with U.S. states. Women aged 50-74 years in the 2016 Behavioral Risk Factor Surveillance System survey without personal history of breast cancer were included. Proportions of women reporting mammography use were calculated. Multivariable logistic regression models were used to compare self-reported mammography use in U.S. territories with all U.S. states. Our total study population included 131,320 women. Of this group, 2,481 were from U.S. territories. In our adjusted analyses, women in the U.S. Virgin Islands were less likely to report mammography use (OR 0.52) compared with women in the U.S. states. Women in other U.S. territories reported mammography at similar rates to U.S. states. Targeted interventions accounting for unique, territory-specific barriers are likely required to improve screening engagement.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Detección Precoz del Cáncer/estadística & datos numéricos , Mamografía/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Etnicidad , Femenino , Humanos , Modelos Logísticos , Persona de Mediana Edad , Puerto Rico , Grupos Raciales , Estudios Retrospectivos , Factores Socioeconómicos , Estados Unidos , Islas Virgenes de los Estados UnidosRESUMEN
OBJECTIVES: Inferior vena cava (IVC) filters are placed to prevent pulmonary embolism, however, some studies have suggested that IVC filters are associated with exacerbated risks of deep vein/IVC thrombosis in cancer patients. The purpose of this study is to determine if cancer patients develop higher than expected rates of venous thromboembolism complications after filter placement compared with noncancer patients. MATERIALS AND METHODS: A retrospective cohort study of consecutive patients who received filters (2002 to 2006) at Johns Hopkins was conducted. Exposures and outcomes were obtained by chart review. Relative risks (RR, 95% confidence interval [CI]) for outcomes in cancer versus noncancer patients were estimated using multistate models. RESULTS: The cohort included 702 patients-246 with cancer and 456 without cancer. Cancer patients were older, more likely to be white and have filters placed for contraindications to anticoagulation (P<0.01). The most common cancers were lung (11.8%) and colorectal (10.6%). Cancer patients had an increase in venous thromboembolism (RR 1.9 [95% CI, 1.1, 3.2]) due to more deep venous thrombosis/IVC thrombosis (RR 1.7 [95% CI, 1.0, 3.0]). Higher pulmonary embolism rates in cancer were not statistically significant (RR 2.2 [95% CI, 0.8, 5.8]). CONCLUSIONS: Cancer patients have elevated risks of thrombotic complications compared with noncancer patients; however, these risks are not higher than expected based on historical controls.