Bakhtiari Ahad, Mostafavi Hakimeh, Mohamadi Efat, Yaftian Fateme, Kargar Sahar, Ahmady Tabatabaei Seyed Vahid, Alimoradi Zainab, Alizadeh Mahasti, Almasi Ali, Amini-Rarani Mostafa, Arab-Zozani Morteza, Ardian Nahid, Asgari Ghorban, Azari Samad, Babaei Majid, Bahri Narjes, Behzadifar Masoud, Dadipoor Sara, Ghavidel Fatemeh, Homaie Rad Enayatollah, Jorjoran Shushtari Zahra, Karimy Mahmood, Kolahi Ali-Asghar, Madani Abdolhossain, Mahmoodi Zohreh, Moradi-Joo Mohammad, Motalebi Kashani Masoud, Mouodi Simin, Najafpoor Ali Asghar, Nakhaee Majid, Namadian Masoumeh, Nojomi Marzieh, Paknazar Fatemeh, Piroozi Bakhtiar, Saki Mandana, Sarikhani Yaser, SoleimanvandiAzar Neda, Soltani Shahin, Tavassoli Elahe, Torabipour Amin, Vazirinejad Reza, Vosoughi Mehdi, Takian Amirhossein, Olyaeemanesh Alireza
Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Iranian Research Network for Social Determinants of Health (IRNSDH), Tehran, Iran.
Health Res Policy Syst. 2025 May 22;23(1):63. doi: 10.1186/s12961-025-01300-4.
Socioeconomic determinants of health (SDH) account for about 40% of modifiable determinants of health, followed by health behaviours (30%), clinical care (20%) and physical environmental factors (10%). The "10/90 gap" is the idea that only 10% of global health research is devoted to conditions that account for 90% of the global disease burden. For over a decade, SDH research centres have been established in Iran to generate evidence and address SDH.
The purpose of this study was to evaluate the activities and challenges faced by SDH research centres and identify knowledge gaps.
We systematically categorized 759 approved projects (2012-2022) from 29 SDH centres using predefined themes (e.g. mental health, COVID-19, social inequalities). Interrater reliability was ensured through dual independent coding, with discrepancies resolved by consensus. In addition, a bibliometric analysis of 5892 PubMed-indexed articles was conducted using VOSviewer, a validated tool for mapping research trends and collaborations. This phase provided objective insights into publication patterns, keyword clusters and interdisciplinary networks. Finally, semi-structured surveys were conducted with SDH researchers to identify knowledge gaps and prioritize research areas. Prioritization criteria (e.g. disease burden, equity impact) were scored using a five-point Likert scale, and the results were validated through an expert panel to ensure alignment with real-world challenges.
Out of the 759 approved research projects gathered from 29 reviewed centres, 79 projects were related to mental health, and 53 were related to coronavirus disease 2019 (COVID-19). A total of 5892 articles from 35 research centres obtained by searching PubMed were reviewed and analysed with VOS viewer software. The most frequently used keywords in the centres' published works are COVID-19, meta-analysis, systematic review, depression, anxiety, and quality of life. In 11 clusters, the 35 research centres under investigation collaborate with 82 additional research centres. Measuring different SDHs at the population level and carrying out related interventions cost far more than the centres' annual budget. Because of this and other factors stated in the results section, the research centres have shifted their focus to smaller research and more accessible and limited groups and subjects.
There is a mismatch between the subjects that the research centres' researchers believe should be studied and the approved projects of the centres, as is evident from a review of the centres' projects and their opinions. Numerous issues may be the root of these discrepancies, such as methods for ranking research subjects, methods for selecting study target groups, how to assess research centres and the different criteria set by colleges and universities.
健康的社会经济决定因素（SDH）约占可改变的健康决定因素的40%，其次是健康行为（30%）、临床护理（20%）和物理环境因素（10%）。“10/90差距”指的是全球健康研究中只有10%致力于解决占全球疾病负担90%的疾病。十多年来，伊朗已设立了SDH研究中心，以生成证据并应对SDH问题。
本研究旨在评估SDH研究中心所开展的活动及面临的挑战，并找出知识差距。
我们使用预定义主题（如心理健康、2019冠状病毒病、社会不平等）对来自29个SDH中心的759个获批项目（2012 - 2022年）进行系统分类。通过双重独立编码确保评分者间信度，分歧通过协商解决。此外，使用VOSviewer对5892篇被PubMed索引的文章进行文献计量分析，VOSviewer是一种用于绘制研究趋势和合作关系的经过验证的工具。此阶段提供了关于发表模式、关键词聚类和跨学科网络的客观见解。最后，对SDH研究人员进行半结构化调查，以找出知识差距并确定研究领域的优先级。使用五点李克特量表对优先级标准（如疾病负担、公平影响）进行评分，结果通过专家小组验证，以确保与现实世界的挑战相符。
在从29个被审查中心收集的759个获批研究项目中，79个项目与心理健康相关，53个项目与2019冠状病毒病（COVID - 19）相关。通过搜索PubMed获得的来自35个研究中心的共5892篇文章，使用VOS viewer软件进行了审查和分析。这些中心发表作品中最常用的关键词是COVID - 19、荟萃分析、系统评价、抑郁、焦虑和生活质量。在11个聚类中，接受调查的35个研究中心与另外82个研究中心开展了合作。在人群层面测量不同的SDH并开展相关干预的成本远远超过这些中心的年度预算。由于这一原因以及结果部分所述的其他因素，研究中心已将重点转向规模较小、更容易接触且范围有限的群体和主题。
从对研究中心的项目及其观点的审查中可以明显看出，研究中心的研究人员认为应研究的主题与中心的获批项目之间存在不匹配。许多问题可能是这些差异的根源，例如研究主题的排名方法、研究目标群体的选择方法、如何评估研究中心以及学院和大学设定的不同标准。
