In this episode of BackTable ENT, pediatric otolaryngologists Dr. Anthony Sheyn (St. Jude Children’s Hospital & Le Bonheur Children’s Hospital), Dr. Jeffrey Rastatter (Lurie Children’s Hospital of Chicago), and Dr. Daniel Chelius (Texas Children’s Hospital), discuss challenges and research in health equity in pediatric head and neck cancer care.

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SHOW NOTES

First, the surgeons define the Social Determinants of Health (SDoH) and explain how studying these factors improves care. They share memories of when they first reckoned with health inequities as clinicians. For Dr. Chelius, this was during medical school, when he observed end-stage renal disease patients’ access to dialysis (and thus lifespan) depended on their insurance status, income, and education. Moving into his residency, he realized that similar forces shaped how patients accessed cancer care. As a young attending, Dr. Sheyn noticed that many of his patients missed appointments for logistical or financial reasons, which piqued his interest in characterizing how SDoH influence pediatric cancer care.

Next, the doctors discuss health equity research. Though they’re based at different institutions, the three surgeons collaborate to study how SDoH affect pediatric head and neck cancer outcomes. Dr. Rastatter shares his work identifying how different SDoH– including socioeconomic status, household composition, housing/transportation, and minority/language status – interact to affect access to cancer care. Dr. Chelius speaks to the importance of social work, advanced practice providers, and transportation services in connecting patients to care. The podcast concludes with a discussion of how tertiary care centers can better collaborate with community clinicians to ensure pediatric patients with rare cancers get the workup and treatment they need.