Analyzing the Interplay between Ethnicity, Socioeconomic and Social Factors in Healthcare

An Interview with Abstract Presenter and 2023 Kosaka Best Scholar Abstract Award Recipient – Annika S. Witt

Abstract Title:

Hispanic Ethnicity and Postoperative Discharge to a Nursing Home: A New York City Hospital Retrospective Study

Category: Perioperative Anesthesia

Poster #: 87

Poster Presentation:

Poster Session G, 11:00 am – 12:00 pm MT, Centennial A-D, The Hyatt Regency Denver at Colorado Convention Center

Oral Presentation:

Kosaka Best Abstracts Awards Session, Sunday, April 16, 2023, 9:30 am – 11:00 am, Centennial E-H, The Hyatt Regency Denver at Colorado Convention Center

Annika Witt, BSc, was conducting psychopharmacology research on mice animal models when she first gained insight into the field of anesthesiology. She was intrigued by its vastness and encouraged by how good practice techniques can genuinely benefit various surgical, procedural and critical care patient cohorts. Prior to beginning medical school this year, Annika was presented with the opportunity to work on a project focused on the Hispanic/Latino community and the risk of postoperative adverse discharge to a nursing home, and she jumped at the chance. Currently, a research fellow in the Department of Anesthesiology at Montefiore Medical Center, Annika has always possessed a strong interest in healthcare disparities and understanding how physicians can work within the limits of the US healthcare system to mitigate them, especially in minority and underserved communities. Over the past year and a half, her contributions to this project have helped it evolve into a robust analysis of the interplay between ethnicity, socioeconomic and social factors. Recognized as the Kosaka Best Scholar Abstract Award Winner with this research, she hopes this study will heighten the understanding of healthcare disparities and create improved efficiencies in healthcare delivery as the US population becomes more diverse. Below, she shares some of the discoveries from this investigation and her aspirations for her future career in medicine.

1. For this research, I am…

an investigator

2. What drew you to the anesthesiology specialty?

Previously, I was conducting psychopharmacology research on mice animal models. I wanted to expand my pharmacological knowledge and learn more about the clinical benefits and implications of anesthesia. To my surprise, I learned how vast the field of anesthesiology is and how good practice techniques can benefit various surgical, procedural and critical care patient cohorts.

3. What drew you to this area of research?

When I started working with Dr. Matthias Eikermann, the group was finalizing a project on Black versus White race and the risk of postoperative adverse discharge to a nursing home, which paved the way for this continuation project on the Hispanic/Latino ethnicity. I jumped at the opportunity as I have always been interested in healthcare disparities and understanding how physicians can work in the limits of the US healthcare system to mitigate disparities, especially in minority and underserved communities.

4. What are the goals you most want to accomplish in your work with this project (or projects)?

Over the past year and a half, this project has evolved into a robust analysis of the interplay between ethnicity, socioeconomic and social factors. The Hispanic paradox has shown that the Hispanic/Latino population have better overall health outcomes despite higher rates of comorbidities and lower socioeconomics. However, when looking at the devasting patient-centered outcome of losing the ability to live independently, this may not be the case – socioeconomic factors and social connections are intricately involved. It is very important for physicians to take these factors, which are strongly linked to ethnicity, into account when discussing discharge planning to prevent false discharge disposition and additional adverse outcomes down the line.

5. What is the potential impact of your research on the field of anesthesia and patient care?

The Pew Research center projects that the Hispanic/Latino population will rise to 128 million (approximately 29% of the US population) by 2050. As the US becomes more diverse in the coming decades, efficiencies in healthcare delivery will not be achieved unless healthcare disparities are understood and addressed. Further, if Centers for Medicare & Medicaid Services (CMS) continue to make cuts and reduce coverage, it may result in a loss of ability to access quality home health services and bring family members home. Discharge planning should consider ethnicity as an important social determinant of health, which is associated with a patient’s risk of postoperative adverse discharge. Knowledge about the interplay between ethnicity and access to potentially necessary postacute care need to be considered to manage family expectations during discharge disposition decision-making.

6. What are the benefits of presenting your research during poster sessions at the IARS Annual Meeting?

The largest benefit to sharing my work at these conferences is raising awareness of disparities within minority communities and increasing interest in research focusing on underrepresented minority patient populations.

7. How do you feel about being recognized as one of the top scholar finalists for the Kosaka Best Abstracts at the IARS 2023 Annual Meeting?

This is my first award at an international conference. I feel incredibly honored to be recognized as a top scholar finalist. I was born and raised in Denver, Colorado so receiving this honor at this annual meeting in my hometown is very special.

8. How do you feel about receiving the Kosaka Best Scholar Abstract Award?

I feel incredibly honored and proud to be the 2023 Kosaka Scholar Abstract Award Winner. It feels amazing to have this project recognized after I spent a long time researching and understanding the complexities of the Hispanic paradox and how it presents itself in the perioperative setting.

9. How will this award affect your research and professional trajectory?

I hope this project’s success and recognition will spark new research in the field of racial and ethnic disparities. For me, this award has jumpstarted my professional career as I begin my medical school journey this July at University of Colorado School of Medicine. There, I seek to continue conducting observational research at the intersection of anesthesiology, disparities, and social determinants of health.

10. How do you envision this opportunity to present your research orally at the awards session will affect your research and professional trajectory?

Receiving this honor to orally present my work is jumpstarting my future medical career and giving me a great foundation for future presentations.

11. Outside of your research, what might someone be surprised to learn about you?

I am trilingual (German, English, and Spanish) and I am excited to start medical school this fall.

12. Is there anyone else you wish to acknowledge as part of this research team?

I want to give a special thank you to Dr. Matthias Eikermann for this incredible opportunity to work on this project and understand the intricacies of this paradox within our diverse patient population. I would also like to acknowledge my entire team and especially Dr. Felix Sterling, Dr. Adela Aguirre-Alarcon, and Luca Wachtendorf for working tirelessly beside me to help understand the complexities of this epidemiologic paradox.