Awareness of racial/ethnic disparities in surgical outcomes and care: factors affecting acknowledgment and action

Am J Surg. 2016 Jul;212(1):102-108.e2. doi: 10.1016/j.amjsurg.2015.07.022. Epub 2015 Oct 29.


Background: Studies have demonstrated racial/ethnic disparities in surgical outcomes and care. Surgeon awareness and its association with institutional action remain unclear. The study sought to assess surgeons' awareness of racial/ethnic disparities, ascertain whether demographic and practice factors influence acknowledgement of disparities, and determine whether surgeons are seeking to mitigate disparities.

Methods: Anonymous online survey was administered to a random sample of American College of Surgeons (ACS) general surgeons (July 2013 to March 2014). Responses were weighted for nonresponse and risk-adjusted using logistic regression.

Results: 172 surgeons completed the survey. Levels of acknowledged disparities were low. Less than one half reported institutional efforts to address disparities, and less than one fourth had taken efforts to investigate disparities in their personal practice. Several respondent factors including Academic Medical Center affiliation, awareness of the ACS statement on optimal access, and year of medical school graduation significantly associated with expressed acknowledgment of disparities.

Conclusions: Such associations speak to the need for continued efforts to promote enhanced provider awareness and participation. As the field of surgical disparities moves from understanding to action, we must acknowledge the contributing role that providers play.

Keywords: Disparities; Intervention; Optimal access; Provider awareness; Surgical disparities.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Attitude of Health Personnel*
  • Awareness*
  • Ethnicity / statistics & numerical data
  • Female
  • Health Care Surveys
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Racial Groups / ethnology
  • Racial Groups / statistics & numerical data
  • Risk Assessment
  • Surgeons / statistics & numerical data
  • Surgical Procedures, Operative / methods
  • Surgical Procedures, Operative / trends
  • Surveys and Questionnaires*
  • United States