Social Determinants of Health and Healthcare Disparities Within Urology

Samuel Washington | May 24, 2023

Welcome to UroToday’s new Center of Excellence on Disparities: Social Determinants of Health. I am honored to serve as its Editor and excited to share new research and expert conversations with you. The World Health Organization and the United States Centers for Disease Control and Prevention define social determinants of health (SDOH) not as individual variables, but as the environments in which people are born, grow, learn, work, play, and age.1,2 Specific characteristics of these environments can either increase or reduce disparities in health, healthcare access, and quality of life among individuals, regions, and nations. This Center focuses on SDOH and healthcare disparities within urology, particularly genitourinary (GU) oncology. However, it is important to emphasize that SDOH affects all persons and all healthcare fields in a multitude of ways, and therefore, many topics covered by this Center will appeal to a broad audience. In this editorial, I outline the current status of GU research on SDOH and disparities, how experts are redefining SDOH and downstream effects in order to improve research and policy, and why it is crucial to engage medically underserved communities in these efforts.


 Neal Shore, MD, FACS

Samuel L. Washington III, MD, MAS Dr. Washington moved from Texas to California to complete his undergraduate education at University of California, Davis with a Bachelors of Science in Genetics, and a minor in Latin. He completed his medical school training at University of California, San Francisco and was selected by the Department of Urology to complete his urology residency.  He stayed on at UCSF to complete his urologic oncology fellowship and a Master’s Degree in Clinical Research. In July 2020, Dr. Washington joined the faculty as an Assistant Professor in the Departments of Urology and Epidemiology & Biostatistics.

He served as a urologic oncologist and faculty within the Department of Urology at University of California, San Francisco. His primary research focuses on racial disparities in patients with genitourinary malignancies, with specific interests in understanding racial/ethnic disparities in diagnosis, management, and treatment and examining and how these differences in treatment strategies based on race and socioeconomic factors impact survival outcomes for patients with GU cancers.

Physician-Scientist Review Articles
State of the Evidence Review Articles
Written by Zachary Klaassen, MD, MSc
August 31, 2020
The rapid spread of Coronavirus Disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) has dramatically reshaped the structure of Western society, including on health care delivery.
Physician-Scientist Commentaries
Peer-reviewed Abstract Supplemental Commentaries
Written by Bishoy M. Faltas
Englander Institute for Precision Medicine, Weill Cornell Medicine
The incidence of genitourinary cancer in the United States is estimated to be approximately 444,660 in 2022 and is expected to increase in the future. This increase will cause a significant economic burden, as the net patient financial burden of prostate cancer and bladder cancer were $3.3 billion and $938 million, respectively. Schafer et al.
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by Daniel George, MD
At the 2023 ASCO annual meeting Dr. Daniel George discussed a prospective trial of apalutamide and abiraterone acetate plus prednisone in black and white men with metastatic castrate-resistant prostate cancer (mCRPC), the PANTHER trial to estimate clinical outcomes among Black and White patients with mCRPC treated with apalutamide, abiraterone, plus prednisone.
Presented by Radhika Bhavsar, MPH
Pulling on her experiences working with global health systems, Professor Radhika Bhavsar, MPH discusses ways we can improve the health of our communities. She describes how often we look to the systems in developed nations to inform how we can build or improve the systems in developing nations. However, she stresses that often we should look to developing nations and apply their successes to help improve the health of communities in the US.
Presented by Desiree Louise Draeger, MD
The 2022 International Kidney Cancer Symposium (IKCS) European Annual meeting included a session addressing non-clinical considerations for caring for the whole kidney cancer patient and a presentation by Dr. Desiree Louise Draeger discussing the psychosocial implications of kidney cancer.