Findings Shared from Transition to Adult Care Presentation
Katherine Bailey, third year MD student at the University of Toronto Temerty Faculty of Medicine and Leong Studentship Recipient, recently presented a poster titled “Social and Structural Determinants of Health Impacting Transition to Adult Care” at the University of Toronto’s Medical Student Research Day on February 21. She provides a summary of her poster presentation.
The transition from a paediatric to adult healthcare provider is often a challenging period for youth with chronic health conditions. These difficulties are likely exacerbated for youth who experience marginalization, as they often navigate further structural barriers related to their transition. Our scoping review aimed to identify the associations between the social and structural determinants of health (SSDOH) and outcomes for youth transitioning to adult care, particularly for those who experience structural marginalization, including Black, Indigenous, and 2SLGBTQ+ youth. We collaborated with three young adults with lived experience to develop our research question and study methods. Our results showed that gender was the most commonly studied SSDOH in transition to adult care. Specifically, gender was significantly associated with inequities related to how healthcare providers communicated with youth, their satisfaction with the transition process, the likelihood that their care was transitioned to an adult provider, and how fast the process occurred. This study identified several gaps in the literature, including limited research identifying the impacts of structural discrimination, such as racism, sexism, homophobia, transphobia, and ableism, on transition outcomes. Additionally, very few studies looked at the SSDOH for youth with mental health and developmental conditions transitioning to adult care, which may experience additional inequities, including accessibility, communication, and stigma. The results of this study highlight where emphasis has been placed in equity and transition to adult care, and will help to inform the development of policies that promote equity in transition. We are currently working on a second part of this review that aims to identify the evidence-based practices that address health inequities in transition for youth experiencing structural marginalization.
