Associations between social determinants of health and pregnancy among young people: A systematic review

Health disparities in pregnancy exist among young people and a social determinants of health (SDOH) approach is currently being promoted to reduce these disparities. However, little research exists identifying empirical links between SDOH and pregnancy among young people. To build a basis of knowledge for moving forward in practice, we conducted a systematic literature review, utilizing the Healthy People 2020 Social Determinants of Health Framework, to analyze empirical associations between determinants and pregnancy among young people.

 This review included studies published between 1988-2012 from databases PubMed, PsycInfo and Academic Search Premier. Twenty-two (N=22) studies were identified that met all inclusion criteria. These studies were assessed for empirical links between determinant areas (e.g., economic stability, social and community context) and pregnancy among young people. Methodological quality was also assessed for each study.

 Seventeen of the 22 studies found an empirical association between at least one SDOH and pregnancy among young people. Areas most represented were economic stability (n=12) and social and community context (n=9). Four studies examined neighborhood and built environment and two examined education. No studies were identified in health and healthcare.

 This review indicates support for existing research that has examined links between pregnancy among young people and social determinants, particularly in the areas of poverty and family structure. However, implications of this research indicate a need to expand the range of social determinants that are analyzed with pregnancy among young people and to focus interventions on areas that have been empirically determined to have a link with pregnancy.