Framing Theoretically Informed Social Determinants of Health Research Questions

Social determinants of health (SDH) are nonmedical factors that directly shape healthcare and outcomes. Over the past 3decades, an enormous amount of effort has been made and is currently ongoing to understand the effect of SDH on health inequities and surgical outcomes. A substantial part of these efforts is grounded in evidence-based research to understand the complex and dynamic influence of these factors on the surgical continuum of care, identifying populations most at risk for resultant disparities and developing effective strategies to mitigate them. While the causes and pathways of these determinants continue to be extensively explored, the gained knowledge has yet to be translated into developing effective strategies and policies to limit inequalities in care. To do so, it is crucial to focus current efforts on developing cost-effective interventions to limit the effect of these disparities on surgical outcomes. Understanding mechanisms through which these factors influence health, and grounding innovative research strategies in theoretical frameworks, is pivotal. This chapter focuses on leveraging research and optimizing aims to address surgical disparities resulting from social and economic factors that influence health outcomes. We present a step-by-step guide on incorporating SDH frameworks in formulating ethically informed research questions to understand the impact of SDH on surgical outcomes and develop effective interventions to mitigate health disparities.