MOAMEN ABDELFADIL ISMAIL, IBRAHIM ALLAH DIWAYA, IBRAHIM NAFEA ALAMRI, NAWAF FALAH JABAR ALWAHBI, LAMA ABDULLAH ALMUJAYDIL, KHADEEJAH MOHAMMED ALHADI ,AMEERA JAMEEL HUSAIN ALI, DALEA ANWAR ALKATHERI, SUMAYIA SALAH YAHIA ZEIKARIA, ELHUSSEIN HASHIM MAHMOUD, HEND MAHMOUD ELSAFI MOHAMED ALI
DOI: https://doi.org/Background: Chronic diseases remain leading causes of global morbidity and mortality, and their burden is increasingly shaped by social determinants of health (SDOH). These include income, education, healthcare access, neighborhood environment, and psychosocial factors that interact with biological risks to influence health trajectories.
Objective: This review synthesizes empirical evidence published between 2010 and 2025 to examine how SDOH contribute to the development, progression, and outcomes of chronic diseases across diverse populations and health systems.
Methods: A systematic review methodology was employed following PRISMA 2020 guidelines. Searches were conducted in PubMed, Scopus, Embase, Web of Science, and Google Scholar. Eligible studies included peer-reviewed research on adults (≥18 years) assessing the relationship between SDOH and chronic diseases. Twenty studies met inclusion criteria, encompassing randomized controlled trials, cohort, case-control, and cross-sectional designs.
Results: Evidence demonstrated that low income, unemployment, educational disadvantage, and limited healthcare access are consistently associated with increased incidence and poorer outcomes of chronic diseases, including cardiovascular disease, diabetes, kidney disease, COPD, and multimorbidity. Cumulative disadvantage amplified mortality risks. Geographic and racial disparities highlighted the interaction of structural inequities with health outcomes.
Conclusion: Findings underscore that chronic disease prevention and management must extend beyond biomedical care to address upstream SDOH. Interventions aimed at reducing income inequality, improving education, strengthening healthcare access, and addressing neighborhood inequities are essential to reduce health disparities globally.
