GRAND ROUNDS REVIEW ARTICLE: Rhinitis disease burden and the impact of social determinants of health.

Social determinants of health (SDH) have substantial impact on patient care and outcomes globally, both in low-to-middle income countries and high income countries. In the clinic, lack of availability of diagnostic tools, inequities in access to care, and challenges obtaining and adhering to prescribed treatment plans may further compound these issues. This article addresses a case of rhinitis in the context of SDH and inequities in care that may affect various communities and populations around the world. SDH may include various aspects of one's financial means, education, access to medical care, environment and living situation, and community factors - each of which could play a role in the rhinitis disease manifestations, diagnosis, and management. Allergic and non-allergic rhinitis are considered from this perspective. Rhinitis epidemiology, disease burden, and risk factors are broadly addressed. Patient evaluation, diagnostic tests, and management options are also reviewed, and issues related to SDH are noted. Finally, inequities in care, knowledge gaps, and unmet needs are highlighted. It is critical to consider SDH and care inequities when evaluating and treating patients for rhinitis and other allergic conditions.

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