Columbia researcher aims to uncover reasons behind health inequities in children after heart surgery

An MBA is a popular degree for people who want to run businesses, but for pediatric cardiologist Brett Anderson, MD, MBA, MS, assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons, the degree helps her focus on improving health quality and outcomes for underserved patients.

"Studies have shown over and over again that inequities in health care exist, and that disadvantaged and minority patients fare worse compared to wealthier patients," says Anderson. "The assumption has been that the disparities are tied to differences in health habits or access to health care among underserved patients."

But when a recent study led by Anderson uncovered disparities in outcomes among children who had heart surgery at premier institutions, she was shocked.

All babies and children in our study who had heart surgery had access to highly specialized cardiac care, no matter where they were from or how complex their condition, so we did not expect to see the large disparities we found. The fact that our study found that payer, race, and neighborhood-level income were all significant predictors of the outcomes we measured speaks to the important, independent effects of all three factors, and really begs the question, why?"

Brett Anderson, pediatric cardiologist at Columbia University Irving Medical Center and NewYork-Presbyterian Morgan Stanley Children's Hospital

Now Anderson is trying to uncover the reasons behind health inequities in this vulnerable population. Recently, she received $1.7 million from the NIH to lead a collaborative effort to identify mechanisms driving disparities in New York state.

An estimated 1 million children in the U.S. are living with congenital heart disease. However, research on outcomes is limited, and little is known about why some children fare better than others.

"Although the data from our previous study came from heart surgery centers across the country, we didn't have enough detailed information to uncover why neighborhood makes such a big difference," Anderson says.

Through a new collaborative with the New York State Department of Health and the 11 hospitals across the state that have performed congenital heart surgeries over the past 15 years, Anderson and her team will have access to more detailed data to better understand and address health inequities across the state for patients with congenital heart disease.

"Factors such as birth environment, prenatal screening, or the time it takes to get referrals or follow-up appointments could be making a difference and may point us toward ways to improve outcomes for all patients with congenital heart problems," Anderson says.

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