Social Determinants of Health in Pediatric Ophthalmology Patients: Availability of Data in the Electronic Health Record and Association With Clinic Attendance.

Purpose: To characterize the availability of social determinants of health data in the electronic health record of pediatric ophthalmology patients and to examine the association of social determinants of health with attendance at scheduled operating room and clinic visits. Methods: This was a retrospective cohort study of pediatric ophthalmology patients seen at The Hospital for Sick Children between June 1, 2018, and May 23, 2022. Data were collected on demographics, diagnosis, and management-plan. The χ2 tests and multivariable regression were used to examine associations between social determinants of health and attendance at scheduled operating room and clinic visits. Results: The cohort consisted of 26,102 study subjects with 31,288 unique eye-related diagnoses representing 57 unique ICD-10 codes. Availability of data in the electronic health record ranged from 100% for sex, age and postal code to 0.1% for ethnic group. Female sex (P = 0.004) and urbanicity (P = 0.05) were associated with higher operating room visit cancellations. Female sex (P = 0.002), age group 0-13 (P ≤ 0.001), low-medium neighborhood income quintile (P ≤ 0.001), residence of Northern Ontario (P ≤ 0.001), and urbanicity (P ≤ 0.001) were associated with higher clinic visit cancellations and no-shows. Conclusions: At a major tertiary-care hospital in Canada, key social determinant data such as ethnicity are not consistently available in the electronic health record of pediatric ophthalmology patients. Female sex, younger age, and living in a rural area or neighborhood with low-medium income quintile may be predictors of missed visits and require further study. Translational Relevance: This study highlights a need for improved documentation of social determinants of health variables in electronic health records.

Racial equity in the fight against COVID-19: a qualitative study examining the importance of collecting race-based data in the Canadian context.

BACKGROUND: A failure to ensure racial equity in response to the COVID-19 pandemic has caused Black communities in Canada to disproportionately be impacted. The aim of the current study was to determine the needs and concerns of Black communities in the Greater Toronto Area (GTA) and to highlight the importance of collecting race-based COVID-19 data early on to address these needs. METHODS: Six qualitative interviews were conducted with local community health centre leaders who serve a high population of racialized communities within the GTA. Content analysis was used to extract the main themes and concerns raised during the interviews. RESULTS: The findings from this study provide further evidence of the disproportionate impact COVID-19 has had on Black and other racialized communities. Difficulty self-isolating due to overcrowded housing, food insecurity, and less social support for seniors were concerns identified by community health leaders. Also, enhanced financial support for front-line workers, such as Personal Support Workers (PSWs), was an important concern raised. In order to lessen the impact of the pandemic on these communities, leaders noted the need for greater accessibility of testing centres in these areas and a greater investment in tailored health promotion approaches. CONCLUSIONS: Overall, our findings point to the importance of collecting race-based data to ensure an equitable response to the pandemic. The current "one size fits all" response is not effective for all individuals, especially Black communities. Not all populations have access to the same resources, nor do they live in the same conditions (Kantamneni, J Vocal Behav 119:103439, 2020). A deeper consideration of the social determinants of health are needed when implementing COVID-19 policies and responses. Also, a lack of attention to Black communities only continues to perpetuate the under-acknowledged issue of anti-Black racism prevalent in Canada.