Lucy C Barker1,2,3,4, Neesha Hussain-Shamsy2,4, Kanya Lakshmi Rajendra5, Susan E Bronskill2,3,4, Hilary K Brown1,2,3,4,6, Paul Kurdyak1,2,3,7, Simone N Vigod8,9,10,11. 1. Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada. 2. Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada. 3. ICES, 2075 Bayview Avenue, Toronto, ON, G1 06M4N 3M5, Canada. 4. Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada. 5. University of Ottawa, 75 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada. 6. Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada. 7. Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada. 8. Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada. simone.vigod@wchospital.ca. 9. Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada. simone.vigod@wchospital.ca. 10. ICES, 2075 Bayview Avenue, Toronto, ON, G1 06M4N 3M5, Canada. simone.vigod@wchospital.ca. 11. Women's College Hospital, 76 Grenville Street, Toronto, ON, M5S 1B2, Canada. simone.vigod@wchospital.ca.
Abstract
PURPOSE: Social determinants of health (SDoH) impact psychiatric conditions. Routinely collected health data are frequently used to evaluate important psychiatric clinical and health services outcomes. This study explored how key SDoH are used in psychiatric research employing routinely collected health data. METHODS: A search was conducted in PubMed for English-language articles published in 2019 that used routinely collected health data to study psychiatric conditions. Studies (n = 19,513) were randomly ordered for title/abstract review; the first 150 meeting criteria progressed to full-text review. Three key SDoH categories were assessed: (1) gender and sex, (2) race and ethnicity, and (3) socioeconomic status. Within each category, data were extracted on how variables were included, defined, and used in study design and analysis. RESULTS: All studies (n = 103) reported on at least one of the key SDoH variables; 102 (99.0%) studies included a gender and/or sex variable, 30 (29.1%) included a race and/or ethnicity variable, and 55 (53.4%) included a socioeconomic status variable. No studies explicitly differentiated between gender and sex, and SDoH were often defined only as binary variables. SDoH were used to define the target population in 14 (13.6%) studies. Within analysis, SDoH were most often included as confounders (n = 65, 63.1%), exposures or predictors (n = 23, 22.3%), and effect modifiers (n = 14, 13.6%). Only 21 studies (20.4%) disaggregated results by SDoH and 7 (6.8%) considered intersections between SDoH. CONCLUSIONS: Results suggest improvements are needed in how key SDoH are used in routinely collected health data-based psychiatric research, to ensure relevance to diverse populations and improve equity-oriented research.
PURPOSE: Social determinants of health (SDoH) impact psychiatric conditions. Routinely collected health data are frequently used to evaluate important psychiatric clinical and health services outcomes. This study explored how key SDoH are used in psychiatric research employing routinely collected health data. METHODS: A search was conducted in PubMed for English-language articles published in 2019 that used routinely collected health data to study psychiatric conditions. Studies (n = 19,513) were randomly ordered for title/abstract review; the first 150 meeting criteria progressed to full-text review. Three key SDoH categories were assessed: (1) gender and sex, (2) race and ethnicity, and (3) socioeconomic status. Within each category, data were extracted on how variables were included, defined, and used in study design and analysis. RESULTS: All studies (n = 103) reported on at least one of the key SDoH variables; 102 (99.0%) studies included a gender and/or sex variable, 30 (29.1%) included a race and/or ethnicity variable, and 55 (53.4%) included a socioeconomic status variable. No studies explicitly differentiated between gender and sex, and SDoH were often defined only as binary variables. SDoH were used to define the target population in 14 (13.6%) studies. Within analysis, SDoH were most often included as confounders (n = 65, 63.1%), exposures or predictors (n = 23, 22.3%), and effect modifiers (n = 14, 13.6%). Only 21 studies (20.4%) disaggregated results by SDoH and 7 (6.8%) considered intersections between SDoH. CONCLUSIONS: Results suggest improvements are needed in how key SDoH are used in routinely collected health data-based psychiatric research, to ensure relevance to diverse populations and improve equity-oriented research.
Authors: Eric I Benchimol; Liam Smeeth; Astrid Guttmann; Katie Harron; David Moher; Irene Petersen; Henrik T Sørensen; Erik von Elm; Sinéad M Langan Journal: PLoS Med Date: 2015-10-06 Impact factor: 11.069
Authors: Lars G Hemkens; Eric I Benchimol; Sinéad M Langan; Matthias Briel; Benjamin Kasenda; Jean-Marie Januel; Emily Herrett; Erik von Elm Journal: J Clin Epidemiol Date: 2016-06-23 Impact factor: 6.437