Racial and Ethnic Disparities Within Social Determinants of Health Amongst Patients With Systemic Lupus Erythematosus.

Introduction This study aims to identify the influence of social determinants of health (SDoH) on patients with systemic lupus erythematosus (SLE), emphasizing racial and ethnic disparities in healthcare. Methods A cross-sectional study used the National Institute of Health's (NIH) All of Us Research Program (AoU). From 727,000 patients, SLE patients were categorized by race, ethnicity, and responses to the Social Determinants of Health survey from May 2018 until March 2023. Survey questions addressed transportation access, neighborhood safety, provider biases, and food insecurity. JMP Pro 16.0 and R 4.2.2 were used for statistical analysis. Results Significant racial disparities were evident amongst SLE patients for transportation access, neighborhood safety, food security, and respect from healthcare providers (p-value < 0.001). African Americans, Asians, and White participants showed different perceptions regarding neighborhood crime, healthcare provider courtesy, and feeling unheard by providers, with respective p-values of 0.001, 0.010, and 0.023. Hispanic participants perceived higher neighborhood crime rates, felt unsafe during nighttime walks, felt unheard by healthcare providers, and reported worrying about food security compared to non-Hispanic participants, with respective p-values of 0.003, 0.003, 0.009, and <0.001.  Discussion SLE is affected by access to care, treatments, stress, and lifestyle habits. Therefore, identifying SDoH for SLE patients is critical as it impacts disease progression, leading to delays in diagnosis, improper management, and worsening morbidity.  Conclusion Targeted social and community-based interventions may improve access to care, identify implicit biases among providers, and alleviate food insecurity.

Medical Educator Perceptions of Faculty Effort and Intent to Stay in Academic Medicine.

Purpose: Core roles of medical school faculty are increasingly diverse, substantial, and evolving. In alignment with this dynamic nature of medical education, faculty effort should be accurately appraised, constantly evaluated, and rewarded to ensure faculty satisfaction and promote a culture of belonging. The study goal was to examine the imbalance in official assignments and perceptions of medical school faculty effort in various educator domains. Materials and Methods: An 80-item survey was designed to collect quantitative and qualitative measures of faculty perceptions of effort. Survey questions collected data on faculty demographics, intent to stay, and perceptions of effort in the following educator domains: teaching, educational leadership and administration, research and scholarship, and service. A mixed methods approach was utilized in data analysis. Results: Eighty-eight complete survey responses were collected between February and May of 2022 from respondents from 27 states. There was a significant disparity between assigned and perceived effort in the educator domains of teaching, research, and service (P < 0.01). Faculty satisfaction with percent effort dedicated to teaching significantly correlated with intent to stay (P < 0.05). Satisfaction with workload assignments was higher with advanced academic rank and male gender. Qualitative analysis identified many key themes in the categories of promotion, workload, resources, and retention. Conclusions: Our study revealed that satisfaction with workload directly correlates with intent to stay, and principles of equitable workload distribution are violated from the perspective of the medical educator. This data provides critical information that can be used to assist medical schools in developing metrics to evaluate faculty performance in medical education and improve retention in academic medicine.