Racial and Ethnic Disparities Among Burn Surgery Leadership

2020 ◽  
Vol 41 (3) ◽  
pp. 714-721 ◽  
Author(s):  
Caroline E Kettering ◽  
Francesco M Egro ◽  
Anisha Konanur ◽  
Brandon T Smith ◽  
Alain C Corcos ◽  
...  
Keyword(s):  
Minority Groups ◽  
Minority Group ◽  
Ethnic Disparities ◽  
The United States ◽  
Academic Rank ◽  
H Index ◽  
Burn Care ◽  
Burn Center ◽  
Major Burn ◽  
Burn Surgery

Abstract The underrepresentation of racial and ethnic minority groups has been well-documented in general and plastic surgery but not in burn surgery. The aim of this study is to evaluate current minority group disparities among burn surgery leadership. A cross-sectional analysis was performed. Burn surgeons included directors of American Burn Association-verified burn centers in the United States, past and current presidents of the American Burn Association, and editorial board members of five major burn journals (Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma). Surgeons were compared based on factors including age, gender, training, academic rank, and Hirsch index (h-index). Among 71 burn center directors, 50 societal presidents, and 197 journal editors, minority groups represented 18.3, 2.0, and 34.5%, respectively. Among burn center directors, the group classified collectively as nonwhite was significantly younger (49 vs 56; P < .01), graduated more recently (2003 vs 1996; P < .01), and had a lower h-index (9.5 vs 17.4; P < .05). There were no significant differences in gender, type of residency training, advanced degrees obtained, fellowships, academic rank, and academic leadership positions between white and nonwhite groups. When compared with the 2018 U.S. National Census, burn unit directors had a 5.1% decrease in nonwhite representation. Disparities in representation of ethnic and racial minorities exist in burn surgery despite having similar qualifying factors.

746 Racial and Ethnic Disparities Among Burn Surgery Leadership

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S206-S206
Author(s):  
Francesco M Egro ◽  
Caroline E Kettering ◽  
Anisha Konanur ◽  
Alain C Corcos ◽  
Guy M Stofman ◽  
...  
Keyword(s):  
Group Representation ◽  
Minority Group ◽  
Ethnic Disparities ◽  
Full Professor ◽  
Academic Rank ◽  
H Index ◽  
Burn Care ◽  
Burn Center ◽  
Major Burn ◽  
Burn Surgery

Abstract Introduction The underrepresentation of racial and ethnic minority groups has existed and been well documented in general and plastic surgery literature but has not been described in burn surgery. The aim of this study is to evaluate current minority group representation among burn surgery leadership. Methods A cross-sectional study was performed in January 2019 to evaluate minority group representation among burn surgery leadership. Burn surgeons included were directors of American Burn Association (ABA)-verified burn centers in the US, past and current presidents of the ABA and International Society of Burn Injuries (ISBI), and editorial board members of five major burn journals (Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma). Surgeons were compared based on factors including age, gender, training, academic rank, and h-index. Results Among 71 burn center directors, 68 societal presidents, and 197 journal editors, minority ethnic groups represented 18.3, 7.4, and 34.5 percent, respectively. Among US burn center directors, the group classified collectively as non-white was significantly younger (white = 56 years, non-white = 49 years; p< 0.01), graduated more recently (white = 1996, non-white = 2003; p < 0.01), and had a lower h-index (white = 17.4, non-white = 9.5; p < 0.05) than white colleagues. There were no significant differences in gender, type of residency training, advanced degrees obtained, and fellowships completed between white and non-white groups.The were no significant differences in the likelihood of white and non-white directors in academia to be full professor, residency or fellowship director, or chair of the department.When compared to the 2018 US National Census, burn unit directors had a 5.1 percent decrease in non-white representation. Specifically, Asians had an 8.3 percent increase in representation, while there was a decrease in both Black (12.0%) and Hispanic (15.3%) representation. Conclusions Disparities in representation of ethnic and racial minorities exist in burn surgery leadership. The most extreme disparities were seen with Black and Hispanic surgeons. However, because these surgeons are younger and graduated more recently, it is promising that minority representation will continue to rise in the future. Applicability of Research to Practice Programs should be initiated in burn surgery that address the implicit biases of burn surgeons and increase mentorship opportunities for underrepresented minorities.

scholarly journals Understanding and Promoting Racial Diversity in Healthcare Settings to Address Disparities in Pandemic Crisis Management

2021 ◽  
Vol 12 ◽  
pp. 215013272110183
Author(s):  
Azza Sarfraz ◽  
Zouina Sarfraz ◽  
Alanna Barrios ◽  
Kuchalambal Agadi ◽  
Sindhu Thevuthasan ◽  
...  
Keyword(s):  
United States ◽  
Health Disparities ◽  
Racial Discrimination ◽  
Clinical Training ◽  
Minority Groups ◽  
Mental Health Problems ◽  
Minority Group ◽  
Healthcare Delivery ◽  
The United States ◽  
Majority Group

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States. Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: Healthcare, raci*, ethnic*, discriminant, hosti*, harass*, insur*, education, income, psychiat*, COVID-19, incidence, mortality, mechanical ventilation. Statistical analysis was conducted in Review Manager (RevMan V.5.4). Unadjusted Odds Ratios, P-values, and 95% confidence intervals were presented. Results: Discrimination in the United States is evident among racial groups regarding medical care portraying mental risk behaviors as having serious outcomes in the health of minority groups. The perceived health inequity had a low association to the majority group as compared to the minority group (OR = 0.41; 95% CI = 0.22 to 0.78; P = .007), and the association of mental health problems to the Caucasian-American majority group was low (OR = 0.51; 95% CI = 0.45 to 0.58; P < .001). Conclusion: As the pandemic continues into its next stage, efforts should be taken to address the gaps in clinical training and education, and medical practice to avoid the recurring patterns of racial health disparities that become especially prominent in community health emergencies. A standardized tool to assess racial discrimination and inequity will potentially improve pandemic healthcare delivery.

scholarly journals A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States

2021 ◽  
Author(s):  
Lauren C Zalla ◽  
Chantel L Martin ◽  
Jessie K Edwards ◽  
Danielle R Gartner ◽  
Grace A Noppert
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Structural Racism ◽  
Public Health Response ◽  
Health Response ◽  
The Us ◽  
Racialized Minority ◽  
Racial And Ethnic Minority ◽  
Disproportionate Burden

Abstract Coronavirus disease 2019 (COVID-19) is disproportionately burdening racial and ethnic minority groups in the US. Higher risks of infection and mortality among racialized minorities are a consequence of structural racism, reflected in specific policies that date back centuries and persist today. Yet, our surveillance activities do not reflect what we know about how racism structures risk. When measuring racial and ethnic disparities in deaths due to COVID-19, the CDC statistically accounts for the geographic distribution of deaths throughout the US to reflect the fact that deaths are concentrated in areas with different racial and ethnic distributions than that of the larger US. In this commentary, we argue that such an approach misses an important driver of disparities in COVID-19 mortality, namely the historical forces that determine where individuals live, work, and play, and consequently determine their risk of dying from COVID-19. We explain why controlling for geography downplays the disproportionate burden of COVID-19 on racialized minority groups in the US. Finally, we offer recommendations for the analysis of surveillance data to estimate racial disparities, including shifting from distribution-based to risk-based measures, to help inform a more effective and equitable public health response to the pandemic.

Racial Health Disparities and Questions of Evidence

2016 ◽  
Author(s):  
Carolyn Moxley Rouse
Keyword(s):  
Health Disparities ◽  
Minority Groups ◽  
Ethnic Disparities ◽  
Structural Data ◽  
The United States ◽  
National Average ◽  
Healthy People ◽  
Making Sense ◽  
Socially Constructed ◽  
Healthy People 2010

The United States Healthy People 2010 initiative, designed to focus nationally funded health research and care on achieving a set of nationwide goals, was directed toward the elimination of racial and ethnic health disparities. While racial and ethnic disparities are complex (with the health of some minority groups surpassing the national average), the health of black Americans continues to fall short of the national average. By focusing on the presumptions embedded in the design of health disparities research, this chapter addresses why Healthy People 2010 largely failed to reduce racial health inequality. Importantly, in thinking about health inequalities, researchers initially failed to consider how race is socially constructed; how data collection is never value-neutral (see King, chapter 8, this volume); and, finally, the limits of randomized control trials (deductive methods) when it comes to making sense of complex behavioral and structural data. The chapter ends by describing how ethnographic insights can help complicate the assumptions and conclusions of health disparities research.

66 The Effect of Transfer on Outcomes in Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S43-S43
Author(s):  
Elizabeth Bruenderman ◽  
Selena The ◽  
Nathan Bodily ◽  
Matthew Bozeman
Keyword(s):  
Tertiary Care ◽  
Total Body Surface Area ◽  
The United States ◽  
Infectious Complications ◽  
Burn Care ◽  
Burn Center ◽  
Total Body ◽  
Tertiary Care Centers ◽  
Inhalation Burn ◽  
Time From Injury

Abstract Introduction Burn care in the United States takes place primarily in tertiary care centers with specialty-focused burn capabilities. Patients are often initially transported to centers without burn capabilities, requiring subsequent transfer to a higher level of care. This study aims to evaluate the effect of this treatment delay on outcomes. Methods Under IRB approval, adult burn patients meeting American Burn Association (ABA) criteria for transfer at a single burn center were retrospectively identified. Cohorts were divided into patients who were initially taken to a non-burn center and subsequently transferred versus patients taken immediately to a burn center. Outcomes between the groups were compared. Results A total of 122 patients were identified, 61 in each cohort. There was no difference between the transfer and direct admit cohorts with respect to median age (52 vs. 46, p = 0.45), percent total body surface area burn (10% vs. 10%, p = 0.08), concomitant injury (0 vs. 4, p = 0.12), or intubation prior to admission (5 vs. 7, p = 0.76). Transfer patients experienced a longer median time from injury to burn center admission than directly admitted patients (1 vs. 8 hours, p &lt; 0.01). Directly admitted patients were more likely to have inhalation burn (18 vs. 4, p &lt; 0.01), require intubation after admission (10 vs. 2, p = 0.03), require an emergent procedure (18 vs. 5, p &lt; 0.01), and develop infectious complications (14 vs. 5, p = 0.04). However, there was no difference between transfers and direct admits in ventilator days (9 vs. 3 days, p = 0.37), number of operations (0 vs. 0, p = 0.16), length of stay (3 vs. 3 days, p = 0.44), or mortality (6 vs. 3, p = 0.50). Conclusions This study suggests that significantly injured, hemodynamically unstable patients were more likely to be immediately identified and taken directly to a burn center. Patients who otherwise met ABA criteria for transfer were not affected by short delays in transfer to definitive burn care. Applicability of Research to Practice Initial triage and evaluation of hemodynamically stable patients at non-burn centers does not negatively impact outcomes in patients who meet ABA criteria for transfer to a burn center.

Educational Attainments of Immigrant Offspring: Success or Segmented Assimilation?

2002 ◽  
Vol 36 (4) ◽  
pp. 1037-1060 ◽  
Author(s):  
Monica Boyd
Keyword(s):  
Second Generation ◽  
Minority Groups ◽  
Minority Group ◽  
The United States ◽  
Small Sample ◽  
Visible Minority ◽  
Foreign Born ◽  
The Third ◽  
Educational Attainments ◽  
Statistics Canada

In this article, I study the educational attainments of the adult offspring of immigrants, analyzing data from the 1996 panel of the Survey of Labour and Income Dynamics (SLID). Fielded annually since 1993 by Statistics Canada, respondents are asked for the first time in 1996 to report the birthplaces of their parents, making it possible to define and study not only the foreign-born population (the first generation), but also the second generation (Canadian born to foreign-born parents) and the third-plus generation (Canadian born to Canadian-born parents). The survey also asked respondents to indicate if they are members of a visible minority group, thus permitting a limited assessment of whether or not color conditions educational achievements of immigrant offspring. I find that “1.5” and second generation adults, age 20–64 have more years of schooling and higher percentages completing high school compared with the third-plus generation. Contrary to the segmented “underclass” assimilation model found in the United States, adult visible minority immigrant offspring in Canada exceed the educational attainments of other not-visible-minority groups. Although the analysis is hampered by small sample numbers, the results point to country differences in historical and contemporary race relations, and call for additional national and cross-national research.

Close Cousins or Distant Relatives? The Relationship Between Terrorism and Hate Crime

2012 ◽  
Vol 58 (5) ◽  
pp. 663-688 ◽  
Author(s):  
Kathleen Deloughery ◽  
Ryan D. King ◽  
Victor Asal
Keyword(s):  
Hate Crime ◽  
Minority Groups ◽  
Terrorist Attack ◽  
Minority Group ◽  
The United States ◽  
Hate Crimes ◽  
Temporal Association ◽  
Daily Data ◽  
Time Series Analyses ◽  
Terrorist Acts

Prior research has frequently drawn parallels between the study of hate crimes and the study of terrorism. Yet, key differences between the two behaviors may be underappreciated in extant work. Terrorism is often an “upward crime,” involving a perpetrator of lower social standing than the targeted group. By contrast, hate crimes are disproportionately “downward crimes,” usually entailing perpetrators belonging to the majority or powerful group in society and minority group victims. The latter difference implies that hate crimes and terrorism are more akin to distant relatives than close cousins. These divergent perspectives provide a backdrop for the present research, which empirically investigates the association between hate crimes and terrorism. In doing so, we contribute to prior work on hate crimes and terrorism by emphasizing the temporal association between these behaviors and by empirically investigating the potential for one kind of violent event to trigger another kind of violence. Time-series analyses of weekly and daily data on terrorism and hate crimes committed in the United States between 1992 and 2008 reveal three primary conclusions. First, we find no evidence to suggest that hate crimes are a precursor to future terrorism. Second, hate crimes are often perpetrated in response to terrorist acts. Third, the latter association is particularly strong for hate crimes perpetrated against minority groups after a non-right-wing terrorist attack, particularly attacks on symbols of core American ideals, indicating that some hate crimes may essentially constitute expressions of retaliation.

An analysis of publication productivity for 1225 academic neurosurgeons and 99 departments in the United States

2014 ◽  
Vol 120 (3) ◽  
pp. 746-755 ◽  
Author(s):  
Nickalus R. Khan ◽  
Clinton J. Thompson ◽  
Douglas R. Taylor ◽  
Garrett T. Venable ◽  
R. Matthew Wham ◽  
...  
Keyword(s):  
Los Angeles ◽  
San Francisco ◽  
The United States ◽  
University Of California ◽  
Academic Rank ◽  
Publication Productivity ◽  
Mathematical Methods ◽  
H Index ◽  
University Of Pittsburgh ◽  
Almost All

Object Bibliometrics is defined as the study of statistical and mathematical methods used to quantitatively analyze scientific literature. The application of bibliometrics in neurosurgery is in its infancy. The authors calculate a number of publication productivity measures for almost all academic neurosurgeons and departments within the US. Methods The h-index, g-index, m-quotient, and contemporary h-index (hc-index) were calculated for 1225 academic neurosurgeons in 99 (of 101) programs listed by the Accreditation Council for Graduate Medical Education in January 2013. Three currently available citation databases were used: Google Scholar, Scopus, and Web of Science. Bibliometric profiles were created for each surgeon. Comparisons based on academic rank (that is, chairperson, professor, associate, assistant, and instructor), sex, and subspecialties were performed. Departments were ranked based on the summation of individual faculty h-indices. Calculations were carried out from January to February 2013. Results The median h-index, g-index, hc-index, and m-quotient were 11, 20, 8, and 0.62, respectively. All indices demonstrated a positive relationship with increasing academic rank (p < 0.001). The median h-index was 11 for males (n = 1144) and 8 for females (n = 81). The h-index, g-index and hc-index significantly varied by sex (p < 0.001). However, when corrected for academic rank, this difference was no longer significant. There was no difference in the m-quotient by sex. Neurosurgeons with subspecialties in functional/epilepsy, peripheral nerve, radiosurgery, neuro-oncology/skull base, and vascular have the highest median h-indices; general, pediatric, and spine neurosurgeons have the lowest median h-indices. By summing the manually calculated Scopus h-indices of all individuals within a department, the top 5 programs for publication productivity are University of California, San Francisco; Barrow Neurological Institute; Johns Hopkins University; University of Pittsburgh; and University of California, Los Angeles. Conclusions This study represents the most detailed publication analysis of academic neurosurgeons and their programs to date. The results for the metrics presented should be viewed as benchmarks for comparison purposes. It is our hope that organized neurosurgery will adopt and continue to refine bibliometric profiling of individuals and departments.

Academic Productivity in Hepatopancreatobiliary Surgeons: Identifying Benchmarks Associated With Rank in North America

2020 ◽  
pp. 000313482096628
Author(s):  
Kelly J. Lafaro ◽  
Amit S. Khithani ◽  
Paul Wong ◽  
Christopher J. LaRocca ◽  
Susanne G. Warner ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
The United States ◽  
Academic Rank ◽  
Academic Productivity ◽  
H Index ◽  
History Of ◽  
Fellowship Council ◽  
Number Of Publications ◽  
Promotion Process ◽  
Nih Funding

Background Academic achievement is an integral part of the promotion process; however, there are no standardized metrics for faculty or leadership to reference in assessing this potential for promotion. The aim of this study was to identify metrics that correlate with academic rank in hepatopancreaticobiliary (HPB) surgeons. Materials and Methods Faculty was identified from 17 fellowship council accredited HPB surgery fellowships in the United States and Canada. The number of publications, citations, h-index values, and National Institutes of Health (NIH) funding for each faculty member was captured. Results Of 111 surgeons identified, there were 31 (27%) assistant, 39 (35%) associate, and 41 (36%) full professors. On univariate analysis, years in practice, h-index, and a history of NIH funding were significantly associated with a surgeon’s academic rank ( P < .05). Years in practice and h-index remained significant on multivariate analysis ( P < .001). Discussion Academic productivity metrics including h-index and NIH funding are associated with promotion to the next academic rank.

820 Transgender Patients with Assault by Burn

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S249-S249
Author(s):  
Uriel J Sanchez ◽  
Clifford C Sheckter ◽  
Yvonne L Karanas
Keyword(s):  
United States ◽  
Medical Care ◽  
Partner Violence ◽  
Public Awareness ◽  
Total Body Surface Area ◽  
The United States ◽  
Care Providers ◽  
Burn Care ◽  
Major Burn

Abstract Introduction The transgender population is estimated at 25 million worldwide and 1 million in the United States. Transgender individuals or those experiencing gender dysphoria are at a higher risk of intimate partner violence and assault (60%) as well as suicide (40%), with reports of 18 transgender individuals killed this year alone in the United States. Trauma and burn care providers need to be aware of this population’s unique medical and surgical needs. To our knowledge, we describe the first reports of burn injuries in transgender patients. Methods We performed a retrospective review of all transgender or gender dysphoric patients admitted to a regional burn center from 2010 to 2019 with a major burn diagnosis (&gt;20% total body surface area). Patients were identified by International Classification of Disease codes in addition to self-identification at time of admission. We describe the mechanism of injury, circumstances surrounding the incident, hospital course, disposition at discharge, and outcomes in clinic follow up. Results The cohort consisted of two patients who were transgender females (i.e. born biologic male and identified as female), aged 31 and 36. Both patients were homeless and had histories of substance abuse and mental health issues. The burn sizes were 20% and 80% and both were flame injuries. One was injured by her domestic partner. The other was injured in a tent fire from a camping stove. The 20% TBSA patient underwent 3 surgeries and was discharged to medical respite on PBD #55. The 80% TBSA patient underwent 9 surgeries and was discharged to inpatient rehabilitation on PBD #75. Regarding their transgender medical care, neither patient was actively being treated by a medical professional although they both reported taking estrogens. Neither patient had undergone transgender surgery. Hormone therapy was not continued during their hospital stay due to lack of information surrounding prior use and limited knowledge regarding the safety of hormonal therapy during burn treatment. Both patients were initially lost to follow up but subsequently reentered our health care system. Both patients have since been referred to our county transgender clinic and are now actively followed by a transgender provider. Conclusions Transgender patients are at high risk for violence and assault, which includes burn. These patients are more difficult to identify and may have inadequate transgender medical care. Burn providers of all levels should be aware of the unique needs of this population and involve transgender medical providers in the acute and rehabilitative care when feasible. Applicability of Research to Practice Raise public awareness regarding assault by burn in the transgender population.

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