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Addressing social determinants of noncommunicable diseases in primary care: a systematic review

Allen, Luke N, Smith, Robert W, Simmons-Jones, Fiona, Roberts, Nia, Honney, Rory and Currie, Jonny 2020. Addressing social determinants of noncommunicable diseases in primary care: a systematic review. Bulletin of the World Health Organization 98 (11) , 754-765B. 10.2471/BLT.19.248278

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Abstract

Objective To explore how primary care organizations assess and subsequently act upon the social determinants of noncommunicable diseases in their local populations. Methods For this systematic review we searched the online databases of PubMed®, MEDLINE®, Embase® and the Health Management Information Consortium from inception to 28 June 2019, along with hand-searching of references. Studies of any design that examined a primary care organization assessing social determinants of noncommunicable diseases were included. For quality assessment we used Cochrane’s tool for assessing risk of bias in non-randomized studies of interventions. We used narrative data synthesis to appraise the extent to which the assessments gathered data on the domains of the World Health Organization social determinants of health framework. Findings We identified 666 studies of which 17 were included in the review. All studies used descriptive study designs. Clinic-based and household surveys and interviews were more commonly used to assess local social determinants than population-level data. We found no examples of organizations that assessed sociopolitical drivers of noncommunicable diseases; all focused on sociodemographic factors or circumstances of daily living. Nevertheless, the resulting actions to address social determinants ranged from individual-level interventions to population-wide measures and introducing representation of primary care organizations on system-level policy and planning committees. Conclusion Our findings may help policy-makers to consider suitable approaches for assessing and addressing social determinants of health in their domestic context. More rigorous observational and experimental evidence is needed to ascertain whether measuring social determinants leads to interventions which mitigate unmet social needs and reduce health disparities.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: World Health Organization
ISSN: 0042-9686
Date of First Compliant Deposit: 24 October 2021
Date of Acceptance: 10 April 2020
Last Modified: 03 May 2023 03:12
URI: https://orca.cardiff.ac.uk/id/eprint/145037

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