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Empowering Equity: Overcoming Socioeconomic Disparities in Breast Reconstruction through Community Engagement Programming
Jane N. Ewing
*1, Chris Amro
1, Mehdi S. Lemdani
1, Zachary Gala
1, Robyn B. Broach
1, Paris D. Butler
2, Joseph Serletti
11Plastic Surgery, University of Pennsylvania, Philadelphia, PA; 2Plastic Surgery, Yale University, New Haven, CT
Introduction: Post-mastectomy breast reconstruction enhances quality of life and self-esteem; however, socioeconomic disparities exist, particularly within race and income status. This study evaluates the impact of community initiatives' ability to mitigate disparities in breast reconstruction.
Methods: We identified Philadelphia metropolitan area patients who underwent free flap breast reconstruction between 2016-2019, comparing their demographics with US Census Bureau data. The study assessed the influence of two key initiatives: Penn Breast Reconstruction Awareness (BRA) Day, aimed at raising awareness and celebrating survivors, and Plastic Surgery Foundation (PSF) sponsored Outreach Symposia, targeting disparity barriers and offering resources across neighborhoods in Philadelphia.
Results: We identified 529 patients who underwent free flap breast reconstruction. Since the implementation of the Outreach Symposia, there was a 17% rise in Black patients within the first year. Patients in the lowest income quartile undergoing reconstruction had a parallel trend of a 26% increase. The representation of both groups matched or surpassed Census Bureau figures each year. On average, 91.1% of symposia attendees were Black, and 71% were from low-income backgrounds. After introducing Penn-BRA Day, community participation notably increased. Attendees from low-income backgrounds grew from 13% to 61%, and Black participation rose from 25% to 55%. Friends and family event attendance also increased by 300%.
Conclusion: The Outreach Symposia and Penn-BRA Day have been instrumental in increasing breast reconstruction among Black and low-income patients, highlighting our institution's commitment and ability to reducing disparities. The rise in community and family involvement highlights the collective effort required to bridge these disparities.
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