Enabling discovery of the social determinants of health: using a specialized lens to see beyond the surface

Investigators encounter challenges in uncovering valuable studies when they are researching health disparities and minority health literature. This evidence scan and qualitative/quantitative crosswalk analysis looked at maternal health literature to gain a better understanding of the nuances in articulating the social determinates of health (SDoH) concepts aligned with the NIMHD Research Framework. SDoH concepts describe the multifaceted causes of health disparities, as opposed to effects that result in health outcomes.

An evidence scan was conducted to identify literature for a health disparity population using infant low birth weight as a sample population. A qualitative and quantitative analysis of results was performed to examine the medical subject headings (MeSH) terms used to index the literature, along with the terminology used to describe various concepts related to the SDoH within the literature. A crosswalk of MeSH terms to SDoH concepts was used to see if a concentrated focus on SDoH concepts would improve discoverability of the literature.

The 31 articles selected demonstrated that 80% of the MeSH indexed keywords are unique within this collection of full text articles, despite the commonality of the topic. VOSviewer and a Python term counting program were used to visualize the diffusion of terminology. NVivo textual analysis revealed SDoH concepts within meaningful phrases within the literature. Major SDoH themes emerged from the analysis, although were not indexed. Authors used a crosswalk approach with SDoH concepts, to demonstrate that MeSH terms could be used to identify content with a more granular SDoH focus.

Identifying literature that has SDoH concepts within the full text is difficult, due to the diffused nature of the terminology used to describe these concepts. This paper proposes to demonstrate how a crosswalk approach from MeSH terminology to SDoH concepts can provide a methodology for improving the discoverability of the literature. New technologies such as natural language processing, combined with existing technologies to normalize disparate ways of describing similar or related constructs, could be used to help discover and synthesize literature related to SDoH. Investigators, indexers, and librarians can work together to create an improved process for researchers.