(184) Evaluating Health Disparities Research in Otolaryngology: A Scoping Review

Introduction: Health disparities in otolaryngology literature have been well-documented over the past 20 years. However, identifying both structural elements of disparities and actionable steps are crucial to achieving health equity. The objectives of this review are to 1) assess existing disparities work within otolaryngology using a public health framework, 2) identify levels of disparities and presence of action items in literature, and 3) suggest improvements for future studies to better work towards health equity.

Methods: Literature review was conducted using PubMed, Web of Science, and Embase databases, identifying articles addressing specific health disparities in otolaryngology in the United States. Head and neck cancer, pediatric, and otology-related articles were excluded. Each article was mapped using a public health research framework proposed by the National Institute on Minority Health and Health Disparities, characterizing disparities on a scale ranging from an individual (based on intrinsic patient characteristics) to a societal (based on existing law or social structure) determinant of health.

Results: Eighty-nine articles met the inclusion criteria of this review. A majority (84%) were published in 2015 or later. Individual determinants of health were the focus of 87% of included studies, while 6% considered a societal determinant. Of all included studies, 26% included actionable steps to address disparities.

Conclusions: While there has been a substantial increase in research investigating health disparities in the last two decades, many of these studies evaluate individual level determinants of health, which do not provide opportunity for intervention. Few studies assess higher level factors that create and maintain health disparities. Furthermore, few studies make actionable recommendations.