Defining Disparities in Cochlear Implantation through the Social Determinants of Health.
Defining Disparities in Cochlear Implantation through the Social Determinants of Health.
复制标题
DOI：
10.1055/s-0041-1739282
复制
发表时间：
2021-11
影响因子：
--
通讯作者：
Bush ML
中科院分区：
文献类型：
--
作者：
Schuh M;Bush ML
听力损失是一个全球性的公共卫生问题，其患病率高，对健康影响深远。人工耳蜗植入（CI）是一种成熟的、基于证据的听力损失治疗方法；然而，不同人群在使用、获取途径和临床结果方面存在显著差异。虽然人工耳蜗植入结果的差异受先天生物学差异的影响，但众多社会、环境和经济因素对最佳结果也有重大影响。听力健康方面的这些差异源于与健康相关的社会经济资源的不平等。为了明确差异并促进人工耳蜗植入的公平性，迫切需要了解并针对这些影响公平结果、获取途径和使用的社会因素。这些因素可根据被广泛接受的健康社会决定因素框架进行分类，包括以下领域：医疗保健获取/质量、教育获取/质量、社会和社区环境、经济稳定性以及邻里和自然环境。本文在人工耳蜗植入的背景下对这些领域进行了定义，并研究了已发表的相关研究以及每个领域研究中的空白。进一步考虑了这些因素如何影响人工耳蜗植入的公平性，以及如何将这些信息纳入接受人工耳蜗植入患者的评估和管理中。
Hearing loss is a global public health problem with high prevalence and profound impacts on health. Cochlear implantation (CI) is a well-established evidence-based treatment for hearing loss; however, there are significant disparities in utilization, access, and clinical outcomes among different populations. While variations in CI outcomes are influenced by innate biological differences, a wide array of social, environmental, and economic factors significantly impact optimal outcomes. These differences in hearing health are rooted in inequities of health-related socioeconomic resources. To define disparities and advance equity in CI, there is a pressing need to understand and target these social factors that influence equitable outcomes, access, and utilization. These factors can be categorized according to the widely accepted framework of social determinants of health, which include the following domains: healthcare access/quality, education access/quality, social and community context, economic stability, and neighborhood and physical environment. This article defines these domains in the context of CI and examines the published research and the gaps in research of each of these domains. Further consideration is given to how these factors can influence equity in CI and how to incorporate this information in the evaluation and management of patients receiving cochlear implants.