Health Inequities in Orthopaedic Trauma Surgery in the United States: A Scoping Review.

J Am Acad Orthop Surg · May 01 2023 · Review

Lee C, Ezell K, Dunford B, Nees D, Jacobsen SM, Staggs J, et al.

From the Office of Medical Student Research, Oklahoma State University Center for Health Sciences (Lee, Ezell, OK

General Orthopaedics

SUMMARY — THE REDUCTIONThis scoping review of 52 studies finds that health inequities—especially by sex, race/ethnicity, and income—are prevalent but understudied in orthopaedic trauma, highlighting a need for further research to improve equitable care.
Abstract, as published

BACKGROUND: Health inequities have been shown to have negative effects on patient care and the healthcare system. It is important for orthopaedic trauma surgeons and researchers to understand the extent to which patients are affected by these inequities.

METHODS: We conducted a scoping review as outlined by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. We searched PubMed and Ovid Embase for articles relating to orthopaedic trauma surgery and health inequities.

RESULTS: After exclusion criteria were applied, our final sample consisted of 52 studies. The most frequently evaluated inequities were sex (43 of 52 [82.7]), race/ethnicity (23 of 52 [44.2]), and income status (17 of 52 [32.7]). The least frequently evaluated inequities were lesbian, gay, bisexual, transgender, and queer identity (0 of 52 [0.0]) and occupational status (8 of 52 [15.4]). Other inequities evaluated included rural/underresourced (11 of 52 [21.1]) and educational level (10 of 52 [19.2]). No trend was observed when examining inequities reported by year.

CONCLUSION: Health inequities exist in orthopaedic trauma literature. Our study highlights multiple inequities in the field that need further investigation. Understanding current inequities and how to best mitigate them could improve patient care and outcomes in orthopaedic trauma surgery.

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