{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:14:45Z","timestamp":1776878085229,"version":"3.51.2"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social determinants of health (SDH), such as race, language, and insurance status, may impact access to surgical care and postoperative outcomes. This study investigates the role of SDH in patients undergoing osteocutaneous free flap reconstruction for mandibular defects due to oral cavity malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of 131 patients at a single tertiary academic center was conducted. Demographic variables and clinical outcomes were extracted from records. The CDC Social Vulnerability Index (SVI) assessed county\u2010level SDH. Outcomes included readmission, reoperation, flap failure, tracheostomy outcomes, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences were observed in clinical outcomes based on race, language, or insurance status. The only significant difference was travel distance, with non\u2010minoritized patients traveling farther (84.7 vs. 44.2\u2009miles,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). SDH metrics did not influence surgical timing or complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a well\u2010supported care setting, equitable access to complex reconstructive surgery may reduce disparities associated with SDH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.28218","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T05:18:19Z","timestamp":1750137499000},"page":"2982-2989","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Social Determinants of Health in Patients Undergoing Osteocutaneous Free Flap Reconstruction for Malignant Disease of the Mandible"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7096-7343","authenticated-orcid":false,"given":"Rohith M.","family":"Bhethanabotla","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1143-1290","authenticated-orcid":false,"given":"Nina","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reta","family":"Behnam","sequence":"additional","affiliation":[{"name":"University of California\u2014San Francisco School of Medicine  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. John","family":"Boscardin","sequence":"additional","affiliation":[{"name":"Department of Medicine and Epidemiology and Biostatistics University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary J.","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chase","family":"Heaton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine C.","family":"Wai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of California\u2014San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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