Social and Structural Drivers of Health and Transition to Adult Care

• DOI: 10.1542/peds.2023-062275
• Publication Date: 2023-12-12T08:25:05Z
• Authors: Katherine Bailey; Julia Avolio; Lisha Lo; Amy Gajaria; Sarah Mooney; Katelyn Greer; Heather Martens; Perrine Tami; Jacklynn Pidduck; Jessie Cunningham; Sarah Munce; Alene Toulany
• Keywords: CINAHL; PsycINFO

CONTEXT Youth with chronic health conditions experience challenges during their transition to adult care. Those marginalized identities likely further disparities in care as they navigate structural barriers throughout transition. OBJECTIVES This scoping review aims identify the social and drivers of (SSDOH) associated outcomes for youth transitioning care, particularly those who marginalization, including Black, Indigenous, 2-spirit, lesbian, gay, bisexual, transgender, queer or questioning, others youth. DATA SOURCES Medline, Embase, CINAHL, PsycINFO were searched from earliest available date May 2022. STUDY SELECTION Two reviewers screened titles abstracts, followed by full-text. Disagreements resolved a third reviewer. Primary research studying association between SSDOH included. EXTRACTION subcategorized drivers, demographic characteristics. Transition classified into themes. Associations assessed according statistical significance categorized significant (P < .05), nonsignificant > unclear significance. RESULTS 101 studies included, identifying 12 (childhood environment, income, education, employment, literacy, insurance, geographic location, language, immigration, food security, psychosocial stressors, stigma) 5 characteristics (race ethnicity, gender, illness type, severity, comorbidity). No studied. Gender was significantly communication, quality life, transfer satisfaction, completion, timing, race ethnicity appointment keeping completion. LIMITATIONS Studies heterogeneous meta-analysis not possible. CONCLUSIONS are inequities outcomes. Understanding these associations is crucial informing interventions mitigating inequities.