Analyses of infectious disease patterns and drivers largely lack insights from social epidemiology: contemporary patterns and future opportunities

Abstract

Background Infectious disease epidemiologists have long recognised the importance of social variables as drivers of epidemics and disease risk, yet few apply analytic approaches from social epidemiology. We quantified and evaluated the extent to which recent infectious disease research is employing the perspectives and methods of social epidemiology by replicating the methodology used by Cohen et al in a 2007 study. Methods 2 search strategies were used to identify and review articles published from 1 January 2005 to 31 December 2013. First, we performed a keyword search of ‘social epidemiology’ in the title/abstract/text of published studies identified in PubMed, PsychInfo and ISI Web of Science, and classified each study as pertaining to infectious, non-infectious or other outcomes. A second PubMed search identified articles that were cross-referenced under non-infectious or infectious, and search terms relating to social variables. The abstracts of all articles were read, classified and examined to identify patterns over time. Results Findings suggest that infectious disease research publications that explicitly or implicitly incorporate social epidemiological approaches have stagnated in recent years. While the number of publications that were explicitly self-classified as ‘social epidemiology’ has risen, the proportion that investigated infectious disease outcomes has declined. Furthermore, infectious diseases accounted for the smallest proportion of articles that were cross-referenced with Medical Subject Headings (MeSH) terms related to social factors, and most of these involved sexually transmitted diseases. Conclusions The current landscape of infectious disease epidemiology could benefit from new approaches to understanding how the social and biophysical environment sustains transmission and exacerbates disparities. The framework of social epidemiology provides infectious disease researchers with such a perspective and research opportunity.

Inequality in acute respiratory infection outcomes in the United States: A review of the literature and its implications for public health policy and practice

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Determinants of patient and health system delay among Italian and foreign-born patients with pulmonary tuberculosis: a multicentre cross-sectional study

“…Incorporating the perspectives and methods of social epidemiology into studies of infectious disease arises many opportunities to control the disease. 12 …”

Social patterning of acute respiratory illnesses in the Household Influenza Vaccine Evaluation (HIVE) Study 2014–2015

“…Surveillance data, for example, are typically lacking individual-level data necessary to capture the impact of social disadvantage on infection outcomes while controlling for potential confounders such as age and household composition. Thus, infectious disease researchers responding to the call for a greater incorporation of social measures into their studies [ 6 , 7 ] are faced with both data and measurement challenges. Nevertheless, consistent positive associations between social disadvantage and risk have been observed with certain infectious diseases such as human immunodeficiency virus [ 8 ], tuberculosis [ 9 – 11 ] and pandemic influenza [ 12 ].…”