Citation

Taylor S, Brayan K, Storch B, Suh Y, Walsh S, Avrith N, Wyler B, Cropano C, Dams-O'connor K. J. Neurotrauma 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2023.0517

PMID

38204190

Abstract

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. However, disparities exist in the populations that acquire TBIs with a greater burden and poorer outcomes associated with communities of color and lower socioeconomic status. To combat health inequities such as these, institutions have begun to target social determinants of health (SDoH) which are environmental factors that affect health outcomes and risks. SDoH may play a role in sustaining a TBI and provide modifiable targets for action to reduce the risk of TBI, especially in high-risk communities. In this study, we describe the existing literature regarding SDoH and their association with sustaining a TBI. We performed a scoping review with a comprehensive search of the Ovid MEDLINE/Embase databases. To summarize the literature, this review adapts the World Health Organization's Commission on SDoH's conceptual framework. Fifty-nine full-text articles, including five focusing on lower and middle-income countries, met our study criteria.

RESULTS of the scoping review indicate that several structural determinants of health were associated with TBI risk. Lower educational attainment and income levels were associated with higher odds of TBI. In addition, multiple studies highlight that minority populations were identified as having higher odds of TBI than their White counterparts. Literature highlighting intermediate determinants of health examined in this review describes associations between sustaining a TBI and rurality, work environment, medical conditions, medication/substance use and adversity. Recommended exploration into lesser-researched SDoH is discussed and the expansion of this review to other aspects of the TBI continuum is warranted.

Language: en

Keywords

ADULT BRAIN INJURY; GERIATRIC BRAIN INJURY; HEAD TRAUMA; HUMAN STUDIES