Trends in Health Disparities, Health Inequity, and Social Determinants of Health Research

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Abstract

The theoretical landscape of health disparities research now emphasizes health inequities and the role that social determinants of health (SDOH) play in creating and perpetuating them. Whether National Institutes of Health (NIH) funding patterns reflect this theoretical shift is unknown.

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The social determinants of health: coming of age.

Paula Braveman, Susan Egerter, David R. Williams (2011)

In the United States, awareness is increasing that medical care alone cannot adequately improve health overall or reduce health disparities without also addressing where and how people live. A critical mass of relevant knowledge has accumulated, documenting associations, exploring pathways and biological mechanisms, and providing a previously unavailable scientific foundation for appreciating the role of social factors in health. We review current knowledge about health effects of social (including economic) factors, knowledge gaps, and research priorities, focusing on upstream social determinants-including economic resources, education, and racial discrimination-that fundamentally shape the downstream determinants, such as behaviors, targeted by most interventions. Research priorities include measuring social factors better, monitoring social factors and health relative to policies, examining health effects of social factors across lifetimes and generations, incrementally elucidating pathways through knowledge linkage, testing multidimensional interventions, and addressing political will as a key barrier to translating knowledge into action.

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What are Health Disparities and Health Equity? We Need to Be Clear

Paula Braveman (2014)

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The use of theory in health behavior research from 2000 to 2005: a systematic review.

Darren Mays, Stephanie E Painter, Denise Hynes … (2008)

Theory-based health behavior change programs are thought to be more effective than those that do not use theory. No previous reviews have assessed the extent to which theory is used (that is, operationalized and tested) in empirical research. The purpose of this study was to describe theory use in recent health behavior literature and to assess the proportion of research that uses theory along a continuum from: informed by theory to applying, testing, or building theory. A sample of empirical research articles (n = 193) published in ten leading public health, medicine, and psychology journals from 2000 to 2005 was coded to determine whether and how theory was used. Of health behavior articles in the sample, 35.7% mentioned theory. The most-often-used theories were The Transtheoretical Model, Social Cognitive Theory, and Health Belief Model. Most theory use (68.1%) involved research that was informed by theory; 18% applied theory; 3.6% tested theory; and 9.4% sought to build theory. About one third of published health behavior research uses theory and a small proportion of those studies rigorously apply theory. Patterns of theory use are similar to reports from the mid-1990s. Behavioral researchers should strive to use theory more thoroughly by applying, testing, and building theories in order to move the field forward.

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Author and article information

Journal

Title: Nursing Research

Abbreviated Title: Nursing Research

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Print): 0029-6562

Publication date Created: 2018

Publication date (Print): 2018

Volume: 67

Issue: 3

Pages: 231-241

Article

DOI: 10.1097/NNR.0000000000000278

PubMed ID: 29698329

SO-VID: f0ae710f-c58f-447e-8821-233466ca353f

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Trends in Health Disparities, Health Inequity, and Social Determinants of Health Research : A 17-Year Analysis of NINR, NCI, NHLBI, and NIMHD Funding

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