Editorial Commentary: The Social Determinants of Health are Insufficiently Reported in the Orthopaedic Literature

Abstract

Socially and economically disadvantaged patients have delays in access to appropriate care, present more severely and to low-volume surgeons and facilities, and achieve lower clinical outcomes than socially advantaged patents. In the United States, 15% live in poverty based upon family income, and evaluation of social determinants of health (SDOH), such as race, ethnicity, employment status, insurance status, education level, and socioeconomic status, is important in helping identify patients at risk. Orthopaedic providers and researchers should collect and report SDOH as routine demographic data. Without an adequate understanding of the historical, institutional, and environmental factors that contribute to an individual's access to health care and subsequent health outcomes, orthopaedic surgeons are effectively neglecting patients' life-course perspective and their biopsychosocial model. Furthermore, we need to understand the value rendered to high-risk patients.