Racial and Socioeconomic Disparities in Neurotrauma: Research Priorities in the New York Metropolitan Area Through a Global Neurosurgery Paradigm

Ernest J Barthélemy; Clémentine K Affana; Zerubabbel K Asfaw; Kristen Dams-O'Connor; Jueria Rahman; Salazar Jones; Jamie Ullman; Konstantinos Margetis; Zachary L Hickman; Neha S Dangayach; Al O Giwa; New York Neurotrauma Consortium Inc

doi:10.1016/j.wneu.2022.06.031

Racial and Socioeconomic Disparities in Neurotrauma: Research Priorities in the New York Metropolitan Area Through a Global Neurosurgery Paradigm

World Neurosurg. 2022 Sep:165:51-57. doi: 10.1016/j.wneu.2022.06.031. Epub 2022 Jun 11.

Affiliations

¹ New York Neurotrauma Consortium, Inc., New York, New York, USA; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA; Center for Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, California, USA. Electronic address: globalneurosurgeon@gmail.com.
² All Saints University School of Medicine, Roseau, Dominica.
³ Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York, USA.
⁴ New York Neurotrauma Consortium, Inc., New York, New York, USA; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵ New York Neurotrauma Consortium, Inc., New York, New York, USA; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York, USA; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York, USA.
⁶ New York Neurotrauma Consortium, Inc., New York, New York, USA; Institute for Neurology and Neurosurgery at North Shore University Hospital, Manhasset, New York, USA.
⁷ New York Neurotrauma Consortium, Inc., New York, New York, USA; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York, USA.
⁸ New York Neurotrauma Consortium, Inc., New York, New York, USA; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁹ New York Neurotrauma Consortium, Inc., New York, New York, USA; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

PMID: 35700861
DOI: 10.1016/j.wneu.2022.06.031

Abstract

The New York Neurotrauma Consortium (NYNC) is a nascent multidisciplinary research and advocacy organization based in the New York Metropolitan Area (NYMA). It aims to advance health equity and optimize outcomes for traumatic brain and spine injury patients. Given the extensive racial, ethnic, and socioeconomic diversity of the NYMA, global health frameworks aimed at eliminating disparities in neurotrauma may provide a relevant and useful model for the informing research agendas of consortia like the NYNC. In this review, we present a comparative analysis of key health disparities in traumatic brain injury (TBI) that persists in the NYMA as well as in low- and middle-income countries (LMICs). Examples include (a) inequitable access to quality care due to fragmentation of healthcare systems, (b) barriers to effective prehospital care for TBI, and (c) socioeconomic challenges faced by patients and their families during the subacute and chronic postinjury phases of TBI care. This review presents strategies to address each area of health disparity based on previous studies conducted in both LMIC and high-income country settings. Increased awareness of healthcare disparities, education of healthcare professionals, effective policy advocacy for systemic changes, and fostering racial diversity of the trauma care workforce can guide the development of trauma care systems in the NYMA that are free of racial and related healthcare disparities.

Keywords: Global neurosurgery; Healthcare disparities; Justice; Neurotrauma; New York Metropolitan Area; Structural racism; Underrepresented minorities.

Publication types

Review

MeSH terms

Health Services Accessibility
Healthcare Disparities
Humans
Neurosurgery*
New York
Poverty
Research