Social determinants of health and outcomes for children and adults with congenital heart disease: a systematic review

Brooke Davey, Raina Sinha, Ji Hyun Lee, Marissa Gauthier, Glenn Flores

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Background: Social determinants of health (SDH) can substantially impact health outcomes. A systematic review, however, has never been conducted on associations of SDH with congenital heart disease (CHD) outcomes. The aim, therefore, was to conduct such a systematic review. Methods: Seven databases were searched through May 2020 to identify articles on SDH associations with CHD. SDH examined included poverty, uninsurance, housing instability, parental educational attainment, immigration status, food insecurity, and transportation barriers. Studies were independently selected and coded by two researchers based on the PICO statement. Results: The search generated 3992 citations; 88 were included in the final database. SDH were significantly associated with a lower likelihood of fetal CHD diagnosis, higher CHD incidence and prevalence, increased infant mortality, adverse post-surgical outcomes (including hospital readmission and death), decreased healthcare access (including missed appointments, no shows, and loss to follow-up), impaired neurodevelopmental outcomes (including IQ and school performance) and quality of life, and adverse outcomes for adults with CHD (including endocarditis, hospitalization, and death). Conclusions: SDH are associated with a wide range of adverse outcomes for fetuses, children, and adults with CHD. SDH screening and referral to appropriate services has the potential to improve outcomes for CHD patients across the lifespan. Impact: Social determinants of health (SDH) are associated with a wide range of adverse outcomes for fetuses, children, and adults with congenital heart disease (CHD).This is the first systematic review (to our knowledge) on associations of SDH with congenital heart disease CHD outcomes.SDH screening and referral to appropriate services has the potential to improve outcomes for CHD patients across the lifespan.

Original languageEnglish (US)
Pages (from-to)275-294
Number of pages20
JournalPediatric Research
Volume89
Issue number2
DOIs
StatePublished - Jan 2021
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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