Collection
Health Equity & Social Determinants
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Equity in pediatric trauma care: screening for social determinants of health
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In this impactful highlight from the 2024 Western Pediatric Trauma Conference, Dr. Meera Kotagal explores the critical role of equity in pediatric trauma care. She emphasizes that improving outcomes for injured children begins with recogniz
video1:24 · Nov 2026
Social determinants of health as drivers of inequities in pediatric injury
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A child's social determinants of health (SDH), including their neighborhood environment, insurance status, race and ethnicity, English language proficiency and geographic location, all significantly impact their risk of injury and outcomes
article · Nov 2026
Strategies for addressing social drivers of health at US trauma centers
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The biopsychosocial model for providing holistic care after traumatic injury requires consideration of the social factors that influence health outcomes in addition to management of physical wounds. Social drivers of health (SDOH) such as i
article · Nov 2026
MassHealth uses census-tract neighborhood stress index scores to adjust payments according to patient social risk — Meera Kotagal, Understanding area-based socioeconomic deprivation indices in health research · 18:57
Addressing health equity in pediatric surgical care in the United States- Progress and challenges
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There are notable inequities in health outcomes for children based on their social determinants of health (SDOH), including where they are born and live, their primary language, their race and ethnicity, socioeconomic status, and more. Thes
article · Nov 2026
Understanding area-based socioeconomic deprivation indices in health research
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This episode is brought to you by Semafor Healthcare. Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, bus
podcast25:17 · Nov 2026
Race is a social construct, not a biological one, challenging historical arguments that genetic factors explain health disparities such as hypertension in African-Americans. — Meera Kotagal, Update Course 2021: DEI – CONCORDANCE AND POST OP COMPLICATION STUDIES · 5:38
Update Course Rewind: Diversity, Equity, and Inclusion 2021
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If you missed our 2021 Pediatric Surgery Update Course, don’t worry. We will recap the event right here on our podcast and today’s episode will highlight one of our favorite sessions on DEI or Diversity, Equity, and Inclusion with Dr. Meera
podcast · Mar 2022
Update Course 2021: DEI – CONCORDANCE AND POST OP COMPLICATION STUDIES
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In this session from the 2021 Update Course, Dr. Meera Kotagal, MD discussed the effects of racial concordance on perioperative outcomes and why it is critical for pediatric surgeons to focus onDiversity, Equity, and Inclusion (DEI).
Art
video · May 2022
The First Generation of Asian American Pediatric Surgical Trainees in North America
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Introduction: Pediatric surgical trainees come from diverse races and ethnicities. However, Asian-Americans (AAs) including West, South, and East Asians may represent a unique group of individuals. We sought to identify any unique challenge
article · Nov 2026
Qualities and characteristics of applicants associated with successful matriculation to pediatric surgery fellowship training
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Background: Pediatric surgery (PS) is among the most competitive fellowship opportunities for general surgery residents. Prior investigations into factors associated with successful matriculation to PS have relied on surveys, which have inh
article · Nov 2026
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Update Course 2021: DEI – CONCORDANCE AND POST OP COMPLICATION STUDIES
African-American children with ASA 1-2 status had over threefold higher 30-day mortality after routine operations compared to other children in the NSQIP database study of 170,000+ children.
Host summaryMeera Kotagal summarizing the discussion — not the host's own clinical position7:10 ↗
African-American children with ASA 1-2 status had 18% greater odds of post-operative complications and 7% greater odds of serious adverse events (cardiac arrest, sepsis) after routine operations.
Host summaryMeera Kotagal summarizing the discussion — not the host's own clinical position7:10 ↗
Black newborns have a 58% reduction in mortality when treated by black physicians, based on Florida data from 1992-2015 covering 1.8 million births.
Host summaryMeera Kotagal summarizing the discussion — not the host's own clinical position13:40 ↗
Racial concordance between physician and newborn affected neonatal mortality but did not impact maternal mortality in the Florida study.
Host summaryMeera Kotagal summarizing the discussion — not the host's own clinical position24:11 ↗
Race is a social construct, not a biological one, challenging historical arguments that genetic factors explain health disparities such as hypertension in African-Americans.
opinionMeera Kotagal5:38 ↗
Anchor bias—when an initial diagnostic decision causes subsequent providers to view the patient through that lens—may contribute to delayed diagnosis in patients presenting multiple times with the same complaint.
clinicalDan4:03 ↗
A highly educated black woman (e.g., a lawyer) has a higher risk of dying in childbirth than a white woman with only a high school education, as demonstrated by Collins from Chicago 20 years ago.
Host summaryGarcia summarizing the discussion — not the host's own clinical position19:22 ↗
Toxic stress and allostatic load have neurobiological mechanisms that contribute to adverse health outcomes, educational attainment, and economic outcomes, with effects beginning in early childhood and even prenatally.
clinicalGarcia19:22 ↗
Michael Marmot's work demonstrated that gainfully employed individuals in the UK National Health System had higher mortality rates the lower they were on the socioeconomic ladder, showing disparities are not unique to racial minorities.
Host summaryGarcia summarizing the discussion — not the host's own clinical position19:22 ↗
Living in the neighborhood around Cincinnati Children's Hospital and not leaving by age 10 has profound negative effects on life expectancy and life trajectory.
Host summaryMeera Kotagal summarizing the discussion — not the host's own clinical position25:03 ↗
Maternal mortality between black and white mothers in the United States differs by over 300%, with young black women dying even when they are residents with access to prenatal care at health institutions.
epidemiologicalLee17:19 ↗
Higher infant mortality in black newborns may be a continuation of physiological stress experienced in utero, including higher prematurity rates.
clinicalLee17:19 ↗
Emergency department literature shows disparities in pain treatment for patients with appendicitis and other conditions, with questions about whether pain is treated equally across patient populations.
clinicalMeera Kotagal13:40 ↗
Gastroschisis mortality is close to zero in the United States due to TPN and NICU resources, but was close to 100% in many resource-limited settings, particularly due to unavailability of TPN and social concerns around the diagnosis.
epidemiologicalMeera Kotagal11:54 ↗
Pipeline programs to increase diversity must start early—not at the college level—to provide opportunities to underrepresented groups.
opinionMeera Kotagal25:03 ↗
The University of Michigan's cultural complications curriculum provides a framework for surgical departments to discuss cases involving bias and gender schemas in a format similar to morbidity and mortality conferences.
clinicalMeera Kotagal25:03 ↗
Addressing health disparities requires moving beyond hospital walls to tackle social determinants of health and poverty at their roots, not just applying band-aids when patients present for care.
opinionMeera Kotagal25:03 ↗
Community-based interventions must be done in partnership and solidarity with community voices, not in isolation, to understand problems from the community's perspective rather than institutional assumptions.
opinionMeera Kotagal29:43 ↗
Understanding area-based socioeconomic deprivation indices in health research
Area-based socioeconomic deprivation indices measure neighborhood context at census tract or zip code level
clinicalMeera Kotagal2:35 ↗
Complex socioeconomic deprivation indices are better predictors of and have better association with health outcomes than any single measure alone
epidemiologicalMeera Kotagal4:42 ↗
The systematic scoping review identified over 3000 articles, which narrowed to over 1000 abstracts after excluding duplicates, yielding 44 potential indices
epidemiologicalMeera Kotagal5:29 ↗
After excluding indices that were too geographically broad or limited to single states, 15 indices remained for review
epidemiologicalMeera Kotagal5:44 ↗
The Social Vulnerability Index (SVI) was developed to assess vulnerability to disaster and includes race because communities with higher proportions of minority individuals are more vulnerable to disaster due to structural racism
epidemiologicalMeera Kotagal7:01 ↗
Most deprivation indices include measures of income/poverty, education, and employment
clinicalMeera Kotagal8:56 ↗
The Social Vulnerability Index used expert consensus to identify which factors should be included
clinicalMeera Kotagal9:19 ↗
Some indices use statistical factor loading methods that weight variables based on how much variation they explain in the sample
clinicalMeera Kotagal9:30 ↗
Most indices output results by percentile rank, but some use absolute values
clinicalMeera Kotagal9:51 ↗
For the Material Community Deprivation Index, the top quintile (top 20% most deprived) contains more variation than the other 80% combined
epidemiologicalMeera Kotagal10:24 ↗
Four of the 15 reviewed indices include race or ethnicity in their composition
epidemiologicalMeera Kotagal12:59 ↗
A neighborhood's racial composition is not in itself a marker of socioeconomic deprivation; race is a social construct, not a biological one
opinionMeera Kotagal13:42 ↗
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