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Disparities: Social Determinants of Health

Curated by clinicians: educational forums with videos, abstracts and conference information

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.

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 Neal Shore, MD, FACS

Samuel L. Washington III, MD, MAS Dr. Washington moved from Texas to California to complete his undergraduate education at the University of California, Davis with a Bachelor of Science in Genetics, and a minor in Latin. He completed his medical school training at the 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 serves as the Helen Diller Family Comprehensive Cancer Center Prostate Cancer Program Community Outreach and Engagement Liaison, Associate Chair for Diversity, Equity, and Inclusion for the Department of Urology, and a member of the National Comprehensive Cancer Network Guidelines for Prostate Cancer Early Detection Panel. His research focuses on understanding how differences in treatment strategies based on race, ethnicity, and socioeconomic (SES) factors impact survival outcomes for patients with genitourinary cancers of the bladder, kidney, and prostate.

Videos
Clinical Conversations by Experts
Urban vs Rural Bladder Cancer Mortality: 20-Year Trend Analysis - Jason Brown
Race-Conscious Medicine in Urology: Shifting from Race-Based Algorithms - Logan Galansky
Neighborhood Deprivation, Race and Ethnicity, and Prostate Cancer Outcomes Across California Health Care Systems - Isla Garraway
Racial Differences in Bladder Cancer Detection Using Blue Light Cystoscopy: A Multi-Center Study - Siamak Daneshmand
The Future State of Race & Ethnicity in Urology: Urology Workforce Projection from 2021-2061 - Efe Chantal Ghanney Simons & Ashley Appleton
Disparities and Underutilization of Aggressive Therapy in Muscle-Invasive Bladder Cancer: An NCDB Analysis - James Ferguson
The Impact of Screening Practices for Black Men - Leanne Woods-Burnham
Analyzing Real-World Impact of Race on ADT Mortality in Prostate Cancer - Judd Moul
Prostate Cancer Foundation's Guidelines for Black Men in the US - Isla Garraway
Socioeconomic Disparities Drive Alarming Racial Gaps in Kidney Cancer Patient Survival Rates - Nirmish Singla
The Complex Interplay of Factors Driving Prostate Cancer Disparities - Steven Patierno
RESPOND Study: A Multi-Faceted Exploration into Prostate Cancer's Racial Disparities - Scarlett Lin Gomez
The Intersection of Technology and Humanitarianism in Urology - Kymora Scotland
Evaluation of Social Determinants of Health and Prostate Cancer Outcomes Among Black and White Patients - Randy A. Vince
Exploring Unique Aspects of Prostate Cancer Research in the VA Healthcare System: Diversity, Disparities, and Future Directions - Isla P. Garraway
Addressing Urological Care Challenges in the South - Lorie Fleck
The Consortium on Disparities of Urologic Conditions (ConDUC): Addressing Disparities in Urologic Conditions and Clinical Trials for African Americans - Curtis A. Pettaway & Walter Rayford
Prostate Cancer Disparities: Addressing Inequities and Empowering Change - Kelvin Moses
Promoting Diversity and Empowering Black Urologists: The R. Frank Jones Urological Society - Linda L. McIntire
Highlighting Bias and Barriers in Urological Care and Prostate Cancer Research - Linda L. McIntire & Tracy M. Downs
Leadership for Health Equity: How the HOPE Commission is Paving the Way for Anti-Racism in Healthcare - Chris Warlick
Treatment Delay Experiences Among Black and White Men with Prostate Cancer - Bhav Jain & Christopher Dee
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 Mahdi Mottaghi
The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a prostate cancer session and a presentation by Dr. Mahdi Mottaghi discussing racial disparities in prostate cancer prediction models, specifically the external validation and comparison of four models of pathological outcome prediction before radical prostatectomy.
Presented by Aditya Sathe, MD
The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Aditya Sathe discussing the genetic causes of bladder cancer in a family with heritable pattern of bladder cancer.
Presented by Ashley Foret
The 2024 Southeastern Section of the AUA (SESAUA) annual meeting featured a bladder cancer session and a presentation by Dr. Ashley Foret discussing the impact of rural location on receipt of standard of care treatment and survival for locally advanced bladder cancer in Louisiana.
Presented by Isla Garraway, MD, PhD
The 2024 American Society of Clinical Oncology Genitourinary (ASCO GU) cancers symposium held in San Francisco, CA between January 25th and 27th was host to a prostate cancer poster session. Dr. Isla Garraway presented the Prostate Cancer Foundation (PCF) screening guidelines for prostate cancer in Black men in the United States.
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.