Inclusion and acknowledgment of social determinants of health in trauma and injury research using national databases: A scoping review.

Abstract

Social determinants of health (SDOH) as defined by the WHO and CDC - socioeconomic status, one's physical environment, racism, discrimination, gender identity, etc. - influence the health of individuals and populations, and are understudied in trauma, injury, and surgical science. This paper quantifies the lack of awareness around excluding SDOH in retrospective injury research studies using large national databases. We reviewed 315 papers in total that use one of three national databases (ACS TQIP, NEISS, and H-CUP NEDS). For each database, we reviewed the four journals that most commonly publish papers using these databases. We conducted a scoping review. We asked two research questions of each article we reviewed: We found that 14.4% of TQIP authors in the examined journals include SDOH; 4.3% of NEISS authors include SDOH; and 83.3% of NEDS authors include SDOH. We also found that 13.6% of TQIP authors mention a lack of measuring SDOH relative to 25.5% of NEISS authors and 27.8% of NEDS authors. This scoping review of SDOH in large national injury databases finds varying levels of inclusion and acknowledgement of SDOH in trauma, emergency medicine, injury, and surgical publications. Health disparities and SDOH affect patients' baseline health status, recovery from illness and injury, and, potential injury recidivism.