Center for Advancing Population Science, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
BMC Public Health. 2023 Mar 1;23(1):410. doi: 10.1186/s12889-023-15274-x.
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.
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.
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.
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.
随着《健康人民 2030 规划》的最近提出,需要从上游角度理解社会决定因素对健康不平等的影响。本综述使用《健康人民 2030 规划》框架,总结了近期关于社会决定因素对不同种族/族裔青少年和青年健康结果影响的证据。
采用系统的、可重复的方法,在 PubMed、Academic Search Premier、PsychInfo 和 ERIC 中进行了检索。共筛选出 2078 篇文章,以确定其是否符合纳入标准。共有 263 篇文章符合纳入标准,最终有 29 篇文章纳入综合分析。
在 29 篇文章中,11 篇为横断面研究,16 篇为队列研究,2 篇为实验性研究。在经济稳定、教育机会和质量、医疗保健机会和质量、邻里和建筑环境以及社会和社区环境等社会决定因素类别中,有 1 项研究评估了自我效能,6 项研究评估了教育程度,10 项研究评估了行为,5 项研究评估了吸烟,11 项研究评估了饮酒,10 项研究评估了物质使用,1 项研究评估了生活质量。本研究中大多数研究结果代表了健康行为,如健康风险行为、吸烟、饮酒和物质使用。在确定的 29 篇文章中,社会决定因素因素存在显著差异,这导致不同种族/族裔青少年和青年的健康结果存在差异,但是差异的幅度因社会决定因素类别而异。
社会决定因素对不同种族/族裔的青少年和青年有不同的影响。生活中的不良经历,加上结构性种族主义,增加了青少年和青年从事危险健康行为的可能性,并在青少年和青年时期对健康结果产生负面影响。需要研究、公共卫生倡议和政策,将社会决定因素纳入生命早期阶段的干预措施,以有效地减少人口层面的社会和健康不平等。