Social determinants of health during the COVID-19 pandemic: a systematic review

Abstract

Introduction: The emergence of COVID-19 has created global transmission. While effective at reducing the spread, public health measures implemented may impact individuals differently leaving them susceptible to the detrimental effects on their health and wellbeing. Therefore this review aims to synthesise the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID-19 pandemic. Methods: A three-step search strategy was used to find both published and unpublished papers. The databases searched included: MEDLINE, CINAHL, EMBASE, and Google Scholar. Following the search, all identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed independently by two reviewers, with meta-synthesis conducted in accordance with JBI methodology. Results: Fifteen papers were included. Three synthesized conclusions were established a) Vulnerable populations groups, particularly those from a racial minority and those with low incomes, are more susceptible and have been disproportionately affected by COVID-19 including mortality; b) Gender inequalities and family violence have been exacerbated by COVID-19, leading to diminished wellbeing among women; and c) COVID-19 is exacerbating existing social determinants of health through loss of employment/income, disparities in social class leading to lack of access to healthcare, housing instability, homelessness and difficulties in social distancing. Conclusions: Vulnerable population groups have been disproportionately impacted by COVID-19, including health outcomes such as hospitalisations and mortality. The COVID-19 pandemic has highlighted the need for action on health inequalities and the social determinants of health. Reflection on social and health policies implemented are necessary to ensure that the COVID19 pandemic does not exacerbate health inequalities into the future. [ABSTRACT FROM AUTHOR]