The social and political events that took place during 2020 and the COVID-19 pandemic brought attention to the widening disparities experienced by disadvantaged communities.

“While we know that these disparities exist in the larger scale in our health care system, when you look at a disease state like pulmonary arterial hypertension [PAH], which is a very serious and very specialized disease, the consequences of these disparities become more amplified,” said Vijay Balasubramanian, MD, FCCP, clinical professor of medicine at the University of California, San Francisco, Fresno.

Dr. Balasubramanian will serve as chair at the CHEST 2022 session Health Care Disparities in PAH on Tuesday, October 18, from 9:15 AM – 10:15 AM CT in Room 104BC. This session will include a panel of speakers that will discuss the significance of race/ethnicity, rurality, and social determinants of health on clinical outcomes in patients with PAH.

“To have an entire session devoted to this topic at a major conference like CHEST reflects the importance of the topic,” Dr. Balasubramanian said. “This session will be putting the discussion of health care disparities front and center.”

Dr. Balasubramanian will open the session with an overview of lessons learned from 2020 and discussion of representation of diverse populations in PAH. Among other topics, he plans to discuss a paper by John J. Ryan, MD, and colleagues published in Advances in Pulmonary Hypertension that specifically looked at health disparities in PAH and the impact of the pandemic.

The second speaker at the session will be Lana Melendres-Groves, MD, vice-dean of diversity, equity and inclusion for the department of medicine and director of pulmonary hypertension at the University of New Mexico, who will discuss the impact of race and ethnicity in PAH.

Roberto Bernardo, MD, MS, director of the Pulmonary Hypertension Program at The University of Oklahoma, will discuss the larger scope of the problem of social determinants of health in PAH. Dr. Bernardo and colleagues also recently published a relevant paper on Hispanic ethnicity and social determinants of health in PAH, using data from the Pulmonary Hypertension Association Registry. The study had several interesting findings, among them that Hispanic adult patients with PAH had a higher frequency of ED visits and hospitalization compared with non-Hispanic White counterparts, despite having a similar disease severity.

“Clearly this topic of disparities in PAH is not very well studied, with most of the data available on the topic only coming out in the last decade,” Dr. Balasubramanian said. “There needs to be an emphasis on these aspects in future studies, and likely should be longitudinal studies looking specifically at disparities.”

Dr. Balasubramanian acknowledged that actionable takeaways from this session will likely vary depending on each attendee’s home region. For example, he said his PAH center is the only center in the entire central valley of California and serves a variety of underserved populations.

“Every physician will get these discussion points to learn from and be able to tailor them to their home practice accordingly,” he said. “They will be able to try to make changes based on the regional challenges they face.”