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Learning Health Systems, Equity, and Bounded Justice: A Critical Scoping Review.

Vivetha Thambinathan1, Katie Lynch1, Maricruz Moya1

  • 1Department of Learning Health Sciences University of Michigan Medical School Ann Arbor Michigan USA.

Learning Health Systems
|March 13, 2026
PubMed
Summary
This summary is machine-generated.

Learning health systems (LHSs) are increasingly incorporating equity, but current approaches are limited. Future research must integrate health justice principles for more robust LHS equity science.

Keywords:
bounded justicecommunity engagementequity sciencehealth equitylearning health systems

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Area of Science:

  • Health Services Research
  • Health Equity
  • Learning Health Systems

Background:

  • The science of learning health systems (LHSs) has expanded to include equity aims.
  • Current efforts to integrate equity into LHSs are still in their early stages.
  • A critical examination of how equity is conceptualized in LHS literature is needed.

Purpose of the Study:

  • To critically examine the discourse surrounding equity within the existing literature on learning health systems.
  • To identify dominant themes and approaches to equity in LHS research.
  • To inform future directions for equity-centered LHS development.

Main Methods:

  • A critical scoping review was conducted, guided by the bounded justice concept.
  • Literature searches were performed across multiple databases (PubMed, Embase, Scopus, CINAHL) up to June 2024.
  • Qualitative descriptive analysis was employed to identify patterns in equity conceptions.

Main Results:

  • Analysis of 40 selected articles revealed four key themes: equity as central, equity as reducing risk, equity as process, and equity defined by population of interest.
  • The majority of articles focused on 'equity as central'.
  • A significant increase in publications occurred between 2020-2024, with five emerging equity-centered LHS approaches identified.

Conclusions:

  • The science of equity in learning health systems is nascent and predominantly reflects narrow, Westernized perspectives.
  • There is a critical need to incorporate health justice traditions more deeply into LHS theory, research, and practice.
  • Future work should broaden the conceptualization and application of equity within LHS.