Washington DC [US], September 1 : Between 2004 and 2018, recipients of heart transplants from socioeconomically disadvantaged communities had a 10 per cent higher relative risk of graft failure and death within five years than those from non-distressed communities.
Additionally, between 2018 and 2022, transplant recipients had a roughly 20 per cent higher relative risk of passing away or having a graft fail within three years than they had before the 2018 UNOS Heart Allocation policy's introduction. This is true even if the percentage of upset patients was the same in both periods.
There are still considerable socioeconomic differences in the American healthcare system. Although structural deprivation has been shown to have an impact on cardiovascular health in previous studies, the effect of community distress on survival after heart transplantation has not been investigated.
The Distressed Communities Index (DCI), which uses neighbourhood variables like unemployment, poverty level, median income, and housing vacancies to measure community socioeconomic inequity, and data from the Organ Procurement and Transplantation Network (OPTN) were both used by the researchers to estimate the number of adult heart transplant patients. 7,450 out of 36,777 heart transplant recipients came from impoverished areas.
The inability to pinpoint transplant centres' locations or proximity to socioeconomically disadvantaged communities, as well as a lack of precise data like test results and operating times, are among the study's drawbacks.
With the discrepancy gap in outcomes expanding with the 2018 Policy Change, structural community distress is associated with lower survival after heart transplantation. For vulnerable groups, new structural and systemic interventions that address social determinants of health are required to improve follow-up treatment and outcomes.
To avoid risk-averse transplantation techniques that would disproportionately harm underserved patients, the DCI should also be included in risk stratification models. The field of heart transplantation must immediately address the growing discrepancy in outcomes due to the COVID19 pandemic's compounding effects, especially on already vulnerable groups.
"While social determinants of health have long been recognized to both shape access to and outcomes following heart transplantation, lack of clear metrics to measure such inequity have limited the development of targeted interventions,” said Sara Sakowitz, a medical student at the David Geffen School of Medicine at UCLA who led the study.
“Our work demonstrates community-level socioeconomic distress is linked with inferior survival following heart transplantation, and further establishes this socioeconomic disparity gap is widening. Changes in policy are needed to address persistent inequities in access to health.”
Disclaimer: This post has been auto-published from an agency feed without any modifications to the text and has not been reviewed by an editor