{'fraction_non_alphanumeric': 0.025668073136427567, 'fraction_numerical': 0.008790436005625879, 'mean_word_length': 5.45124716553288, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
CORR Insights®: What is the Impact of Social Deprivation on Physical and Mental Health in Orthopaedic Patients?

In the current study, Wright and colleagues [12] performed a crosssectional evaluation for nearly 5 months in an orthopaedic center, matching Patient-Reported Outcomes Measurement Information System (PROMIS) scores to the Area Deprivation Index (ADI). The ADI is “a composite measure of communitylevel social deprivation” [12] and it was used to estimate individual social deprivation. The authors found that patients living in zip codes with the highest levels of social deprivation had worse PROMIS scores compared with patients living in the leastdeprived quartile. The authors also determined that subspecialties were distinct in terms of the ADI of patients seen—39% of trauma patients were from themost-deprived quartilewhereas only 11% of patients in a sports medicine practice were from the most-deprived quartile [12]. Although the results from the current study are consistent with those of another study on social deprivation and patient-reported outcomes [10], they remain an important addition to our growing knowledge about the effect of social deprivation on health care by focusing on the orthopaedic implications, as opposed to general health outcomes. It is also meaningful to orthopaedic surgeons, because it shows variability between specialties, which is a novel discovery. One could argue that our understanding of healthcare disparities in the United States has been refined considerably during the past 20 years. In 1999, Congress requested an Institute of Medicine (IOM) study regarding health disparities, resulting in the 2002 publication of Unequal Treatment: Confronting Racial and Ethnic Disparities in Heath Care [6]. Much of the research in the IOM study (and since its release) has focused on racial and ethnic differences, which persist even within equivalent socioeconomic classes. Importantly, just as race and ethnicity are beyond an individual’s control, so too is social deprivation. Yet, both of these uncontrollable factors can effect health and patient-reported outcomes. Why is it so important to define the relationship between patient-reported outcomes and social deprivation? Because the US healthcare system contains disincentives to caring for socially deprived patients. For example, lower-income individuals are more likely to be uninsured or to have Medicaid, which provides lower reimbursement than do private insurance and Medicare. Lower-income patients are less likely to adhere to recommended medical treatments [4]. If some groups of patients—such as those with greater social deprivation or those with Medicaid insurance (or less)—have lower scores at baseline, payment models need to adjust for this so these already vulnerable individuals do not have less access to care.