The social determinants of health and health outcomes among adults during the COVID-19 pandemic: A systematic review.

ABSTRACT

OBJECTIVE: To synthesize the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID-19 pandemic. INTRODUCTION: COVID-19 has created widespread global transmission. Rapid increase in individuals infected with COVID-19 prompted significant public health responses from governments globally. However, the social and economic impact on communities may leave some individuals more susceptible to the detrimental effects. METHODS: A three-step search strategy was used to find published and unpublished papers. Databases searched included MEDLINE, CINAHL, EMBASE, and Google Scholar. All identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed 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 health care, housing instability, homelessness, and difficulties in physical distancing. CONCLUSION: Reflection on social and health policies implemented are necessary to ensure that the COVID-19 pandemic does not exacerbate health inequalities into the future.