Social Determinants of Health Factors for Gene–Environment COVID‐19 Research: Challenges and Opportunities

Abstract

The characteristics of a person's health status are often guided by how they live, grow, learn, their genetics, as well as their access to health care. Yet, all too often, studies examining the relationship between social determinants of health (behavioral, sociocultural, and physical environmental factors), the role of demographics, and health outcomes poorly represent these relationships, leading to misinterpretations, limited study reproducibility, and datasets with limited representativeness and secondary research use capacity. This is a profound hurdle in what questions can or cannot be rigorously studied about COVID‐19. In practice, gene–environment interactions studies have paved the way for including these factors into research. Similarly, our understanding of social determinants of health continues to expand with diverse data collection modalities as health systems, patients, and community health engagement aim to fill the knowledge gaps toward promoting health and wellness. Here, a conceptual framework is proposed, adapted from the population health framework, socioecological model, and causal modeling in gene–environment interaction studies to integrate the core constructs from each domain with practical considerations needed for multidisciplinary science.

Similarities and differences in Alzheimer’s dementia comorbidities in racialized populations identified from electronic medical records

“…Furthermore, in the context of dementia, a previous study suggested that accounting for socioeconomic factors such as income and formal education level may mitigate differences in dementia incidence between Black- and White- identified individuals 47 . There are a number of challenges obtaining individual-level SDoH in the EMR 48 , including the lack of systematic inclusion. However, several community-level SDoH can be assessed for patients with known addresses, including median income, food access 49 , and environmental pollution 50 , though using these broader SDoH indicators to describe individuals have important limitations 51 .…”

Utilizing Electronic Medical Records Identifies Similarities and Differences in Alzheimer’s Disease Comorbidities Between Racialized Populations

“…Furthermore, in the context of dementia, a previous study suggested that accounting for socioeconomic factors such as income and formal education level may mitigate differences in dementia incidence between Black-and Whiteidentified individuals 37 . While there are current challenges to identifying individual-level SDoH in the EMR 38 , several community-level SDoH can be assessed for patients with known addresses, including median income, food access 39 , and environmental pollution 40 , though using these broader SDoH indicators to describe individuals have important limitations 41 . We plan to identify strategies to properly incorporate SDoH in future work.…”

Understanding the inclusion and participation of adults from Black African Diaspora Communities (BAFDC) in health and care research in the UK: a realist review protocol

“…For example, doses for the drug warfarin, a blood-thinning drug, have been reported as being prescribed based on an individual’s race and ethnicity, despite genetic studies mainly being conducted on European and white Americans 31. There is also evidence to suggest that there is some misunderstanding among biomedical researchers around the differences between sociopolitical constructs like race and ethnicity and biological factors such as genetic ancestry, which can lead to estimates of genetic heredity being biased if environmental and social determinants of health are taken into consideration during analysis 33. Enabling representation of people from BAFDC in health and care research is critical for innovation and new discoveries; data science; ensuring access to specific therapeutic drugs, or treatments; building trust in science and medicine; addressing health disparities and ensuring provision of evidence-based healthcare 14 34.…”

“… 31 There is also evidence to suggest that there is some misunderstanding among biomedical researchers around the differences between sociopolitical constructs like race and ethnicity and biological factors such as genetic ancestry, which can lead to estimates of genetic heredity being biased if environmental and social determinants of health are taken into consideration during analysis. 33 Enabling representation of people from BAFDC in health and care research is critical for innovation and new discoveries; data science; ensuring access to specific therapeutic drugs, or treatments; building trust in science and medicine; addressing health disparities and ensuring provision of evidence-based healthcare. 14 34 Without this, there is a risk of perpetuating health inequalities and social injustice with data producing algorithms used to guide treatment decisions based on White populations.…”