Incorporating Social Determinants of Health in Infectious Disease Models: A Systematic Review of Guidelines

Shehzad Ali, Zhe Li, Nasheed Moqueet, Seyed M. Moghadas, Alison P. Galvani, Lisa A. Cooper, Saverio Stranges, Margaret Haworth-Brockman, Andrew D. Pinto, Miqdad Asaria, David Champredon, Darren Hamilton, Marc Moulin and Ava A. John-Baptiste
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Shehzad Ali: Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
Zhe Li: Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
Nasheed Moqueet: Public Health Agency of Canada, Ottawa, ON, Canada
Seyed M. Moghadas: Agent-Based Modelling Laboratory, York University, Toronto, ON, Canada
Alison P. Galvani: Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA
Lisa A. Cooper: Department of Medicine, Johns Hopkins University School of Medicine, USA
Saverio Stranges: Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
Margaret Haworth-Brockman: Department of Sociology, University of Winnipeg, MB, Canada and National Collaborating Centre for Infectious Diseases, Winnipeg, MB, Canada
Andrew D. Pinto: Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada and Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
David Champredon: Public Health Agency of Canada, National Microbiological Laboratory, Guelph, ON, Canada
Darren Hamilton: London Health Sciences Centre, London, ON, Canada
Marc Moulin: London Health Sciences Centre, London, ON, Canada
Ava A. John-Baptiste: Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

Medical Decision Making, 2024, vol. 44, issue 7, 742-755

Abstract: Background Infectious disease (ID) models have been the backbone of policy decisions during the COVID-19 pandemic. However, models often overlook variation in disease risk, health burden, and policy impact across social groups. Nonetheless, social determinants are becoming increasingly recognized as fundamental to the success of control strategies overall and to the mitigation of disparities. Methods To underscore the importance of considering social heterogeneity in epidemiological modeling, we systematically reviewed ID modeling guidelines to identify reasons and recommendations for incorporating social determinants of health into models in relation to the conceptualization, implementation, and interpretations of models. Results After identifying 1,372 citations, we found 19 guidelines, of which 14 directly referenced at least 1 social determinant. Age ( n  = 11), sex and gender ( n  = 5), and socioeconomic status ( n  = 5) were the most commonly discussed social determinants. Specific recommendations were identified to consider social determinants to 1) improve the predictive accuracy of models, 2) understand heterogeneity of disease burden and policy impact, 3) contextualize decision making, 4) address inequalities, and 5) assess implementation challenges. Conclusion This study can support modelers and policy makers in taking into account social heterogeneity, to consider the distributional impact of infectious disease outbreaks across social groups as well as to tailor approaches to improve equitable access to prevention, diagnostics, and therapeutics. Highlights Infectious disease (ID) models often overlook the role of social determinants of health (SDH) in understanding variation in disease risk, health burden, and policy impact across social groups. In this study, we systematically review ID guidelines and identify key areas to consider SDH in relation to the conceptualization, implementation, and interpretations of models. We identify specific recommendations to consider SDH to improve model accuracy, understand heterogeneity, estimate policy impact, address inequalities, and assess implementation challenges.

Keywords: social determinants of health; infectious disease models; modelling guidelines; equity; pandemic (search for similar items in EconPapers)
Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:44:y:2024:i:7:p:742-755

DOI: 10.1177/0272989X241280611

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