Health Disparities

Health disparities: Health disparities are defined as variation in rates of disease occurrence and outcomes between sociodemographic and/or geographically defined population groups. Significant disparities in care and treatment outcomes are documented across many areas of Otolaryngology—Head and Neck Surgery. In addition to clinical risk factors, sociodemographic factors, such as race/ethnicity, gender, socioeconomic status, geography, and insurance status, exert a powerful influence on disease severity, access to care, and treatment outcomes. This is most prevalent in head and neck cancer. African Americans, uninsured/underinsured patients, and patients with low socioeconomic status have poor outcomes. They are more likely to be diagnosed with advanced disease, are less likely to receive adequate treatment, resulting in lower survival rates. The mechanisms that drive these disparities are not yet clearly understood. Our research efforts have focused on evaluating the impact of sociodemographic and clinical factors on access to care, quality of care, outcomes. These studies have identified disparities in care patterns and survival outcomes for patients with head and neck cancer. Furthermore, they have revealed areas of opportunity for further studies aimed at understanding and addressing health disparities. Our current research focuses on understanding drivers of sociodemographic disparities in head and neck cancer outcomes.

Cancer Epidemiology & Outcomes

Head and neck cancer and thyroid cancer are important causes of morbidity and mortality. Head and neck cancer is the seventh most common cancer in the world. It accounts for approximately 10% of cancers, with an estimated 130,000 new cases annually in the United States. Head and neck cancer is an important cause of cancer mortality, with an average 5-year cumulative survival of 65% in the United States. Thyroid cancer is the most rapidly increasing cancer in the US. The incidence increased from 4.56 per 100, 000 person-years in 1974-1977 to 14.42 per 100,000 person-years in 2010-2013. Our research efforts have focused on examining incidence trends in thyroid and head and neck cancer among various population groups, and comparing the effectiveness of treatments and healthcare delivery methods for these cancers, using large datasets. These studies have provided much needed information on how to most effectively treat these patients.

Hearing Loss

Hearing loss is the fourth highest cause of disability globally, with 466 million people suffering from disabling hearing loss worldwide. Approximately 48 million people in the US ages 12 and older suffer from hearing loss in at least one ear. Hearing loss is associated with diminished quality of life due to communication difficulties and limitations in activities of daily living. Hearing loss is also associated with cognitive decline in the elderly, and is one of the most significant potentially modifiable risk factors of dementia. Despite the high prevalence of hearing loss, and its significant impact on health and quality of life, many individuals with hearing loss do not receive adequate hearing healthcare. Our research efforts focus on evaluating the impact of hearing loss on health outcomes, and addressing barriers to hearing healthcare access.

Health Literacy

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate decisions regarding their health. It is estimated that 90 million adults in the United States have inadequate health literacy. Health literacy has been shown to impact outcomes in a number of medical conditions. Management of diseased of the head and neck, especially cancer, is extremely complex and involves coordination of care across multiple disciplines. This increases the health literacy requirements for patients, who have to assimilate new information and make complex decisions at times of physical and emotional stress. Despite the high complexity of care required in this patient population, there is very little scientific research literature on health literacy in otolaryngology patients. Our research efforts focus on evaluating the impact of health literacy on patient-physician communication and outcomes in otolaryngology patients.