Disparities in Delirium across the Continuum of Care and Associations with Social Determinants of Health

Author:

Khanna Anu1,Govil Malvika2,Ayele Nohamin3,Saadi Altaf4ORCID

Affiliation:

1. Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts

2. Department of Neurology, New York Langone Health, New York University Grossman School of Medicine, New York City, New York

3. Department of Neurology, Northwestern Medicine, Feinberg School of Medicine, Chicago, Illinois

4. Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts

Abstract

AbstractDisparities exist in the identification, treatment, and management of delirium. These disparities can be most holistically and comprehensively understood by using a social–ecological model—which acknowledges multilevel impacts including individual, interpersonal, organizational, community, and policy-level factors—as well as a social determinant of health framework, that considers nonmedical factors that influence health outcomes. This narrative review leverages both frameworks to identify and discuss existing literature pertaining to the intersection of these social risk factors and delirium, focusing specifically on disparities due to racial and/or ethnic identity, language ability, and socioeconomic differences. We also look at disparities and the potential role of these social risk factors throughout the continuum of care, including prehospitalization, hospitalization, and posthospitalization factors. Understanding and analyzing the role of these inequities is critical to ensuring better health outcomes for patients at risk of and/or with delirium.

Publisher

Georg Thieme Verlag KG

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