Socioeconomic deprivation and health inequity: independently associated with postoperative outcomes, and does this matter?

Abstract

Health inequities are unjust disparities in health between groups of people, typically described in terms of sex, race and ethnicity, or socioeconomic position. The COVID-19 pandemic highlighted significant ongoing health inequities across the United Kingdom and worldwide. We believe that socioeconomic deprivation is the single most important driver of health inequity. For patients having surgical treatments, it is clear that socioeconomic deprivation is an important risk factor for poor patient outcomes. However, there is overlap with other important risk factors such as smoking and obesity. We discuss recent work that describes the associations between socioeconomic deprivation and short-term patient outcomes after surgery. We explore the difficulties in identifying risk factors for poor patient outcomes that can be modified by perioperative teams, and why it is important not to confuse modifiable risks with the underlying drivers of health inequity.