Stephanie Lovinsky-Desir, MD, MS, discusses the importance of addressing social determinants of health (SDOH) to improve outcomes in pediatric respiratory health.
One of the things that drew me to the field of pediatric pulmonology is the fact that children are so vulnerable, said Stephanie Lovinsky-Desir, MD, MS, a pediatric pulmonologist at Columbia University Medical Center and incoming director of that program. Lovinsky-Desir's talk was presented at this year's American Thoracic Society's (ATS) annual conference.
Can you give an overview of your talk "Addressing Structural and Social Determinants of Health" at this year's ATS meeting?
I think that what my talk will focus a bit on are some of these societal, environmental, and structural factors that contribute to respiratory diseases in our population. I think that there's been an awakening in the last year, although many of us investigators have known about this for a period of time, a lot of factors in the social environment that influence the health of people. What opportunities [do they have]? Where do people live? Where do people have opportunities to work? Where do children have opportunities to play? All of these factors can play a role in their overall health, particularly respiratory health.
What challenges are unique to pediatric pulmonology patients when it comes to social and structural determinants of health?
I think one of the things that drew me to the field of pediatric pulmonology is the fact that children are so vulnerable. They can't choose where they live, they can't choose where they go to school, they can't choose where they have opportunities for play. It's these specific factors that they have no control over, but that influence their health, that make them so vulnerable. I feel like it's my duty as a clinician, but also as somebody who wants to have a broader reach, to really think about how do we influence public health in a way [so] that these children, obviously, don't have to think about these things, and their parents shouldn't have to think about these things, and that every child should be able to live a healthy, happy life.
What are some of the main areas in respiratory health affected by SDOH? Is it clinical trial recruitment, treatment access, disease management, or is it across the board?
I absolutely think it's across the board. There are multiple factors that influence health overall, and social determinants play a role in each one of those factors. We actually have a manuscript that was recently accepted for publication where we talk about some of the strategies for improving recruitment and retention of underrepresented minorities in clinical trials and research studies, because we know that if new interventions come on the market or become available, if they're not studied in all different populations, they may have differential effects on different people or different groups.
Another study that I'll be highlighting in my talk, during this conference, focuses on hospitals and the resources that certain hospitals have compared to others. How resourced the hospital is has a direct influence on the outcomes of the patients who go to those hospitals. Underrepresented minorities may be more likely to go to underresourced hospitals, and that might be the reason why there's poor outcomes and poor health. I think there are a multitude of factors that need to be addressed. This is something that needs to be looked at, on multiple different levels at multiple different angles.