Researchers are calling for studies on social determinants of health (SDoH) to include race in their analyses to advance racial health equity.
Though SDoH interventions have a unique opportunity to address longstanding racial health inequities, a recent study from researchers at the University of California San Diego Health shows few of the studies on social needs interventions include analyses on race and ethnicity, making it difficult to understand intervention outcomes among minoritized racial and ethnic populations.
For the study, published in JAMA Network Open, the research team reviewed 152 studies conducted in multiracial or multiethnic populations. Of those, only 44 studies included race or ethnicity analyses, and of those 44, only four were “conceptually thoughtful for understanding root causes of racial health inequities,” explained researchers.
Of the total studies, 21 of them reported whether intervention outcomes differed by race or ethnicity and 23 studies included race or ethnicity in their analyses as confounders. Nearly nine in 10 of the total number of studies did not assess whether intervention outcomes varied by race or ethnicity.
The lack of race and ethnicity data included in SDoH analyses is a barrier to further advancements in health equity for vulnerable populations, according to the authors. “Because of the persistent and pervasive nature of racism, it is likely that social needs interventions operate differently in minoritized racial and ethnic populations,” wrote researchers. “Failure to assess for differential outcomes by race or ethnicity prevents us from understanding whether minoritized racial and ethnic populations benefit from interventions at least as much as white populations prevent us from advancing our understanding of how social needs interventions can reduce racial or ethnic health inequities.”
The researchers attribute the poor data collection to several factors, including a lack of awareness of the importance to do so, limited knowledge of how racism is linked to SDoH and poor health outcomes, and a lack of standards for reporting on race or ethnicity. Continued education around the conceptualization of race and ethnicity, and the risks behind not including it in research, is key to improved data collection in the future, noted researchers.
“Our findings pointed to a wide gap between expectations of these interventions’ potential to advance health equity and their design, conduct, and reporting,” they said. “To advance the field, future work should use a theoretically sound conceptualization of how racism affects social drivers of health and use this understanding to inform methodological approaches to developing, implementing, and evaluating social needs interventions.”