Hispanic Ethnicity and Social Determinants of Health in Pulmonary Arterial Hypertension: The Pulmonary Hypertension Association Registry

Bernardo, Roberto; Lü, Di; Ramírez, Ramón Limón; Hedlin, Haley; Kawut, Steven M.; Bull, Todd; Marco, Teresa De; Ford, H. James; Grinnan, Daniel; Klinger, James R.; McConnell, John W.; Rosenzweig, Erika B.; Shlobin, Oksana A.; Zamanian, Roham T.; Perez, Vinicio A. de Jesus

doi:10.1513/annalsats.202109-1051oc

Cited by 17 publications

(26 citation statements)

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“…Using data from PHAR, we recently performed a comprehensive characterization of Hispanic patients with PAH not only in terms of demographic and clinical factors but their social and economic profiles. 33 Hispanic patients were younger, had higher frequency of congenital heart disease, had higher pulmonary pressures and pulmonary vascular resistance, but had no major differences in WHO functional class, exercise capacity, natriuretic peptides, or PAH therapy.…”

Section: Sdoh In Hispanics: Data From Pharmentioning

confidence: 94%

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Hispanic Ethnicity and Social Determinants of Health: Harnessing Data from The Pulmonary Hypertension Association Registry

Bernardo

Perez

2022

Advances in Pulmonary Hypertension

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Pulmonary arterial hypertension (PAH) is a chronic, progressive, and debilitating disease associated with increased cardiopulmonary morbidity and mortality. Current knowledge is derived from registries and landmark clinical trials, although concern exists that minorities are underrepresented in these datasets, and it remains unknown if there are intrinsic differences in minorities and disadvantaged groups. The Pulmonary Hypertension Association Registry offers a unique opportunity for the understanding of the unique social background of minorities in the United States because it routinely collects information related to socioeconomic factors such as annual income and health care insurance. Furthermore, representation of Hispanic patients may be slightly higher than in other US-based registries. In this review, we discuss the interplay between biologic, socioeconomic, and racial or ethnic factors in PAH, with special emphasis on the Hispanic population. We describe the unique socioeconomic profile of Hispanic individuals and propose next steps to improve representation and fight inequality for Hispanic patients with PAH.

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Section: Sdoh In Hispanics: Data From Pharmentioning

confidence: 94%

“…Lower-income patients face several challenges regarding PAH care, such as inability to afford the cost of medications or medical testing. 10,33…”

Section: Sdoh In Hispanics: Data From Pharmentioning

confidence: 99%

Hispanic Ethnicity and Social Determinants of Health: Harnessing Data from The Pulmonary Hypertension Association Registry

Bernardo

Perez

2022

Advances in Pulmonary Hypertension

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“…Using data from PHAR, we recently performed a comprehensive characterization of Hispanic patients with PAH not only in terms of demographic and clinical factors but their social and economic profiles. 33 Hispanic patients were younger, had higher frequency of congenital heart disease, had higher pulmonary pressures and pulmonary vascular resistance, but had no major Hispanic patients had a disadvantageous socioeconomic profile as compared with non-Hispanic Whites. Hispanics had lower education level, had lower annual income, were less likely to be employed or retired, and were less likely to have access to Medicare or commercial insurance (Figures 4A-4D).…”

Section: Sdoh In Hispanics: Data From Pharmentioning

confidence: 96%

“…Examination of SES in systemic sclerosis suggests that higher wealth and more equitable access to health care services may mitigate increased mortality attributable to specific ethnic groups. 33 Current guidelines and management algorithms do not factor the effect of SES on the disease process. However, from the emerging data it is evident that SES plays an important role in health-related quality of life and clinical outcomes.…”

Section: Ses and Pahmentioning

confidence: 99%

“…National Organization for Rare Disorders believes that effectively integrating telehealth into our health care system will lead to better outcomes for RD patients by reducing barriers care, shortening the time it takes to get an accurate diagnosis, and increasing access to providers with RD expertise. In support of these goals, we developed principles 33 to help guide our telehealth policy efforts. To date, many states and private insurance companies have already integrated aspects of telehealth into their plans and programs, yet there is more work to be done.…”

Section: Advances In Pulmonary Hypertensionmentioning

confidence: 99%

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2022

Advances in Pulmonary Hypertension

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Social determinants of health in pulmonary arterial hypertension patients in the United States: Clinician perspective and health policy implications

et al. 2022

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Social determinants of health (SDoH) can impact the vulnerable pulmonary arterial hypertension (PAH) population, especially during the COVID‐19 pandemic. Providers' understanding of SDoH at the point of care and their impact is unknown. We conducted semi‐structured virtual interviews with US clinicians at 17 pulmonary hypertension (PH) centers and one patient advocate from the Pulmonary Hypertension Association. We sought participants' perspective on SDoH in PAH and their impact. Transcripts were developed and analyzed for key themes to assess potential policy implications. Participants served a large PAH population and demonstrated high awareness of SDoH and its impact on treatment and outcomes. They reported that patients' SDoH, including socioeconomic status, health insurance, access to health care, education levels, health literacy, employment status, and insecurities associated with housing, food, transportation, and family support, impacted health and well‐being. COVID‐19‐related social isolation, mental health, and substance abuse contributed to significant inequities in care provision and outcomes. While telemedicine helped clinicians manage patients remotely during the pandemic, there was a concern for patients with limited access to this medium. Participants reported no formal screening for SDoH at the point of care. With the recognition and the desire to act upon health inequities associated with SDoH, participants felt that it was vital for their centers to have a dedicated PH social worker and support staff to optimize care and outcomes. An approach that integrates SDoH in PAH care management, streamlined through institutional policy, could address health disparities leading to improved healthcare access, outcomes, and quality of care.

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Hispanic Ethnicity and Social Determinants of Health in Pulmonary Arterial Hypertension: The Pulmonary Hypertension Association Registry

Cited by 17 publications

References 38 publications

Hispanic Ethnicity and Social Determinants of Health: Harnessing Data from The Pulmonary Hypertension Association Registry

Hispanic Ethnicity and Social Determinants of Health: Harnessing Data from The Pulmonary Hypertension Association Registry

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Social determinants of health in pulmonary arterial hypertension patients in the United States: Clinician perspective and health policy implications

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