Racial/ethnic differences in social determinants of health and health outcomes among adolescents and youth ages 10–24 years old: a scoping review

Abstract

Introduction With the recent emergence of the Healthy People 2030 goals there is a need to understand the role of SDOH on health inequalities from an upstream perspective. This review summarizes the recent body of evidence on the impact of SDOH across adolescence and youth health outcomes by race/ethnicity using the Health People 2030 Framework. Methods A systematic, reproducible search was performed using PubMed, Academic Search Premier, PsychInfo, and ERIC. A total of 2078 articles were screened for inclusion. A total of 263 articles met inclusion criteria, resulting in 29 articles included for final synthesis. Results Across the 29 articles, 11 were cross-sectional, 16 were cohort, and 2 were experimental. Across SDOH categories (economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context), 1 study examined self-efficacy, 6 educational attainment, 10 behavior, 5 smoking, 11 alcohol use, 10 substance use, and 1 quality of life. The majority of outcomes represented in this search included health behaviors such as health risk behavior, smoking, alcohol use, and substance use. Across the 29 articles identified, significant differences existed across outcomes by race/ethnicity across SDOH factors, however magnitude of differences varied by SDOH category. Discussion SDOH differentially affect adolescents and youth across race/ethnicity. The lived adverse experiences, along with structural racism, increase the likelihood of adolescents and youth engaging in risky health behaviors and negatively influencing health outcomes during adolescence and youth. Research, public health initiatives, and policies integrating SDOH into interventions at early stage of life are needed to effectively reduce social and health inequalities at a population level.

Opportunity and accessibility: an environmental scan of publicly available data repositories to address disparities in healthcare decision-making

“…Disaggregated data were most commonly available for age, sex, geography, deprivation, and urbanization, but inequality patterns among other important dimensions (e.g., disability, race and ethnicity, sexual orientation) were very limited. The scarcity of data on drivers of health such as race or ethnicity and sexual orientation is a significant evidence gap as these factors are known to impact health outcomes and access to healthcare [ 42 , 43 ]. Furthermore, despite ample reporting on sex and gender, the absence of clear definitions, lack of transparency on how these data were collected, and their reporting as binary variables could potentially mean that sex and gender were being used interchangeably and were therefore conflated [ 44 – 47 ].…”

Prediabetes Prevalence by Adverse Social Determinants of Health in Adolescents

“…Our findings are similar to those from a cross-sectional study by Ogden et al 24 that demonstrated differing associations between obesity and household income among youth across race and ethnicity groups, with high household income associated with lower obesity prevalence among Asian and Hispanic youths, but no income-related difference among White and Black youths. Similarly, a scoping review of associations between SDOH and health risk behaviors (eg, substance use, high-risk sexual behavior) among adolescents and young adults aged 10 to 24 years 25 found that associations differed across racial and ethnic groups and by SDOH assessed. These findings underscore the complexity of the associations among racial and ethnic identity, exposure to adverse SDOH, and health outcomes in youths.…”

“…Similarly, a scoping review of associations between SDOH and health risk behaviors (eg, substance use, high-risk sexual behavior) among adolescents and young adults aged 10 to 24 years 25 found that associations differed across racial and ethnic groups and by SDOH assessed. These findings underscore the complexity of the associations among racial and ethnic identity, exposure to adverse SDOH, and health outcomes in youths.…”

Caregiver Quality of Life During Pediatric Influenza-Like Illness: A Cross-Sectional Study During the COVID-19 Pandemic

“… 19 These multifaceted changes in quality of life may be affected by social determinants of health and family contextual factors. 20 , 21 Additionally, racial disparities exist in pediatric ED outcomes, including appendicitis care, diagnostic imaging, antibiotic usage, gastroenteritis, and pain management. 22 – 26 These known racial disparities in emergency care and outcomes suggest that there may be racial disparities in other important measures, including caregiver QoL.…”