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The following is a summary of “Health Equity and Emergency Colorectal Surgery in the United States: A Scoping Review,” published in the March 2025 issue of the Journal of Surgical Research by Byrd et al. 

Patients requiring emergency colorectal surgery represent a particularly high-risk segment of the broader emergency general surgery population, often experiencing disproportionate rates of postoperative complications, elevated mortality, extended hospital stays, and increased healthcare costs. Existing evidence suggests that, within this vulnerable group, disparities in care and health outcomes are prevalent and may be influenced by a range of social determinants. Despite growing attention to health equity in surgical care, a complete understanding of the structural and demographic factors contributing to inequities in emergency colorectal surgery remains underdeveloped. 

This systematic review aimed to evaluate and synthesize the current literature on disparities and inequities in the delivery and outcomes of emergency abdominal colorectal surgery in the United States over the past decade. Utilizing two established equity-focused frameworks—PROGRESS (which includes place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital) and the Phases of Health Disparity Research framework—research performed a structured search across MEDLINE, Embase, and Web of Science Core Collection databases. 

Articles were included if they assessed disparities, inequities, or social determinants among U.S. patients undergoing emergency abdominal colorectal procedures between 2014 and 2024. A total of 22 studies met the inclusion criteria. The vast majority of these studies (86%) concentrated on racial and ethnic disparities, while socioeconomic indicators—such as income, insurance status, and neighborhood-level economic measures—were also frequently addressed. In contrast, key components of the PROGRESS framework, such as gender, religion, education level, social support networks, and primary language, were comparatively underexplored. 

Most studies involved patients with malignant colorectal diseases and were classified within the “detecting” phase of the Phases of Health Disparity Research framework, indicating an early stage of understanding where disparities are identified but not yet thoroughly investigated in terms of underlying causes or interventions. These findings reveal substantial gaps in the literature regarding the multifactorial contributors to health inequities in emergency colorectal surgery. The limited scope of variables considered in most studies underscores the need for a broader, intersectional approach that captures not only traditional demographic indicators but also measures of structural disadvantage, such as institutional racism, healthcare access, and education inequality. Addressing these deficiencies in future research will be critical for informing policy and practice interventions aimed at reducing disparities, improving outcomes, and promoting equitable care for all patients undergoing emergency colorectal surgery. 

Comprehensive, equity-informed research is essential to moving beyond the detection phase toward designing and implementing systemic changes that support health justice in acute surgical settings.

Source: journalofsurgicalresearch.com/article/S0022-4804(25)00037-X/fulltext