Health disparities and associated social determinants of health in interstitial lung disease: a narrative review.

IF 9 1区 医学 Q1 RESPIRATORY SYSTEM
European Respiratory Review Pub Date : 2025-04-02 Print Date: 2025-04-01 DOI:10.1183/16000617.0176-2024
Gabriella Tikellis, Anne E Holland
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引用次数: 0

Abstract

Background: Health disparities are prevalent across respiratory diseases. Social determinants of health are closely associated with health disparities and account for between 30% and 55% of all health outcomes. In people with interstitial lung disease (ILD), disparities have the potential to significantly impact access to care and health outcomes along many stages of the disease journey.

Aim: This review aimed to provide an overview of health disparities in ILD, focusing on the determinants of health and access to care from diagnosis to end of life and to report on some approaches being proposed to address these disparities.

Methods: A narrative review of the literature was undertaken using three electronic databases (Ovid Embase, Medline and CINAHL) from inception to May 2024. Disparities and social determinants were mapped to the domains of the Dahlgren-Whitehead model of social determinants of health.

Results: A total of 31 studies were eligible for inclusion. Common disparities identified included differences in antifibrotic utilisation, representation in clinical trials, access to ILD care and lung transplantation waiting lists. Associated social determinants included race/ethnicity, gender, geography and socioeconomic status. Paradoxically, telehealth technology and utilisation have the potential to improve access to diagnostic and treatment options for marginalised communities but may exacerbate disparities for those with lower digital literacy and access.

Conclusion: Reducing health disparities in ILD will require an awareness and understanding of the root cause of the disparities at both the individual and societal level in order to develop effective interventions that improve access to care for all living with ILD.

间质性肺病的健康差异和相关的健康社会决定因素:叙述性综述
背景:健康差异在呼吸系统疾病中普遍存在。健康的社会决定因素与健康差异密切相关,占所有健康结果的30%至55%。在间质性肺病(ILD)患者中,差异有可能在疾病历程的许多阶段显著影响获得护理和健康结果。目的:本综述旨在概述ILD的健康差异,重点关注从诊断到生命终结的健康决定因素和获得护理的机会,并报道一些提出的解决这些差异的方法。方法:采用三个电子数据库(Ovid Embase, Medline和CINAHL)从成立到2024年5月进行文献综述。差异和社会决定因素被映射到Dahlgren-Whitehead健康社会决定因素模型的领域。结果:共有31项研究符合纳入条件。确定的常见差异包括抗纤维化应用、临床试验代表性、获得ILD护理和肺移植等待名单的差异。相关的社会决定因素包括种族/民族、性别、地理位置和社会经济地位。矛盾的是,远程保健技术和利用有可能改善边缘化社区获得诊断和治疗选择的机会,但可能会加剧数字素养和获取机会较低的人的差距。结论:减少ILD的健康差异需要在个人和社会层面上认识和理解差异的根本原因,以便制定有效的干预措施,改善所有ILD患者获得护理的机会。
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来源期刊
European Respiratory Review
European Respiratory Review Medicine-Pulmonary and Respiratory Medicine
CiteScore
14.40
自引率
1.30%
发文量
91
审稿时长
24 weeks
期刊介绍: The European Respiratory Review (ERR) is an open-access journal published by the European Respiratory Society (ERS), serving as a vital resource for respiratory professionals by delivering updates on medicine, science, and surgery in the field. ERR features state-of-the-art review articles, editorials, correspondence, and summaries of recent research findings and studies covering a wide range of topics including COPD, asthma, pulmonary hypertension, interstitial lung disease, lung cancer, tuberculosis, and pulmonary infections. Articles are published continuously and compiled into quarterly issues within a single annual volume.
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