Exploring Social Determinants of Health and Their Significance in Real-World Evidence Research

In public health, the concept of social determinants of health (SDOH) has gained significant attention as a key factor influencing individual and community well-being. Unlike the more traditional focus on medical care and genetic factors, SDOH encompasses the broader socio-economic conditions that affect health outcomes. This post explores the various aspects of SDOH, their impact, why they are essential in achieving health equity and their importance in real world evidence (RWE) research.

What Are Social Determinants of Health?

SDOH are the conditions in which people are born, grow, live, work, and age. These factors, which include socioeconomic status, education, neighborhood and physical environment, employment, social support networks, and access to healthcare, significantly influence health outcomes.


Key Social Determinants of Health


1. Economic Stability: Economic stability involves factors such as employment, income, expenses, and financial security. Individuals with stable employment and adequate income are more likely to afford healthcare services, nutritious food, and safe housing, all of which contribute to better health.

Impact: Unemployment and low income can lead to stress, poor nutrition, inadequate housing, and limited access to healthcare, resulting in poorer health outcomes.


2. Education: Education influences health literacy, employment opportunities, and income potential. Higher levels of education are linked to better health outcomes due to increased health awareness and access to resources.

Impact: Limited educational opportunities can lead to lower health literacy, reduced earning potential, and higher risk of health issues.


3. Neighborhood and Physical Environment: The quality of housing, access to transportation, availability of green spaces, and exposure to pollutants are critical components of one's physical environment. Safe and healthy environments contribute to better physical and mental health.

Impact: Poor housing conditions, pollution, and lack of safe recreational areas can increase the risk of chronic diseases and mental health issues.


4. Social and Community Context: Social support networks, community engagement, and experiences of discrimination or violence significantly affect health. Strong social connections and community support foster mental well-being and resilience.

Impact: Social isolation, discrimination, and community violence can lead to stress, mental health disorders, and increased risk of chronic diseases.


5. Health and Healthcare: Access to healthcare services and the quality of care received are crucial determinants of health. This includes the availability of preventive services, treatment for illnesses, and health education.

Impact: Lack of access to healthcare or poor-quality care can result in untreated conditions, late diagnosis, and overall poorer health outcomes.


Why Are Social Determinants of Health Important?

Understanding and addressing SDOH is essential for several reasons:


1. Health Equity: By focusing on SDOH, public health initiatives can address disparities and promote health equity.


2. Prevention: Addressing SDOH can help prevent health issues before they arise by improving living conditions and reducing risk factors.


3. Comprehensive Care: Considering SDOH leads to more holistic and patient-centered care, acknowledging that health is influenced by more than just biology and medical treatment.


4. Cost Savings: Preventive measures and addressing root causes of health problems can reduce healthcare costs associated with treating chronic and acute conditions.


Why Social Determinants of Health Are Important for Real-World Evidence Research?

Real-world evidence (RWE) research involves collecting and analyzing data from real-world settings to understand health outcomes, treatment effectiveness, and healthcare practices. In recent years, there has been an increase in studies linking real-world data (RWD) with social determinants of health (SDOH) to support public health. SDOH are being integrated into models for disease screening and identifying social risks that can influence health outcomes. Enriching RWD with SDOH allows for the identification of populations at higher risk for certain health issues, enabling targeted and more effective early intervention strategies. By understanding the impact of social and environmental factors on health and healthcare access, health systems and providers can address these factors, reduce health disparities, and improve health equity. However, identifying SDOH information and appropriately linking it to clinical and public health data is challenging. Informatics approaches such as natural language processing (NLP), ontologies, and spatiotemporal data integration offer promising solutions to tackle these challenges. Nonetheless, there is still a lack of standardization among RWD vendors and healthcare systems regarding how and which SDOH information should be collected. This leads to inconsistencies in the collected data and presents a challenge for the use and exchange of SDOH data across different systems.

SDOH are integral to RWE research as they provide a comprehensive understanding of the various factors influencing health outcomes. By incorporating SDOH, researchers can identify health disparities, enhance predictive models, inform policies, promote patient-centered care, address root causes of health issues, and support diverse populations. This holistic approach ensures that healthcare interventions are more effective, equitable, and tailored to the real-world conditions in which people live. Ultimately, integrating SDOH into RWE research leads to better health outcomes and a more just healthcare system.