Authors : Olayemi Michael Lawanson; Ahmed Abu-Halimeh; Oluwatomiwa Ajiferuke

Volume/Issue : Volume 10 - 2025, Issue 6 - June

Google Scholar : https://tinyurl.com/35vkxz4d

DOI : https://doi.org/10.38124/ijisrt/25jun1277

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Note : Google Scholar may take 30 to 40 days to display the article.

Abstract : Investment in the healthcare sector has long been viewed as a means of ensuring that everyone has access to health services in the United States, a nation with a predominately privatized health system. Nonetheless, there is mounting evidence that other non-health factors frequently have a significant impact on the utilization of healthcare services. The access to and usage patterns of health services are influenced by socioeconomic variables, which have a significant impact on health outcomes. Access to healthcare is more readily available to the affluent than to those in poorer socioeconomic conditions. In order to achieve the Sustainable Development Goals (SDGs), it is imperative that more people have access to health care. This study examined the effect of socioeconomic status (SES) and other social and economic factors on the health of immigrants in the US, using secondary data. The primary focus of this review was the socio-economic factors that influence health outcomes in the US. It conducted a review on how socioeconomic factors affect US health outcomes. Without regard to chronological constraints, the research was carried out by searching through the databases of pertinent publications and only contained papers written in English. Included studies were those that analyzed socioeconomic factors as key variables in healthcare access and usage among US residents. The results of this study demonstrate that, in developed nations, especially the US, a variety of health outcomes, including the usage and accessibility of health care services, have been linked to occupation, higher income, education, ethnicity/racism, and poverty status. The majority of the evaluated research has demonstrated a correlation between various health outcomes and socioeconomic variables. The study concluded that social and economic determinants play a critical role in shaping health outcomes and healthcare access in the US. In order to address non-medical, social determinants of health within the framework of the health care delivery system, policies should be implemented to include health outcome considerations into non-health policy sectors.

Keywords : Socio-Economic Characteristics. Health Systems, Health Outcomes, Healthcare Access.

References :

1. Huynen M, Martens P, Hilderink H. (2005). The health impacts of globalization: a conceptual framework. Global Health, 1(1):14. [PMC free article] [PubMed] [Google Scholar]
2. Bayati M, Akbariyan R, Kavosi Z, Sadraei Javaheri A, Amini Rarani M, Delavari S. (2012). Socioeconomic determinants of health in the countries of West Pacific: analysis of panel data. Social Welfare, 12 (47): 111–30. [Google Scholar]
3. Brooks E, Burns D, Gamble K, et al. (2002). Strategies for public health: a compendium of ideas, experience and research from Minnesota’s public health professionals. Vol. 2 Minnesota: Minnesota Department of Health. [Google Scholar]
4. Emamgholipour, S, Nakhaei M, Kazemi Karyani A, Ghazanfari S. (2015). Decomposition socioeconomic inequality in infant mortality in EMRO countries. Int J Pediatr, 3(4–1): 749–56. [Google Scholar]
5. Garoon, J.P., and P.S. Duggan (2008). ‘Discourses of Disease, Discourses of Disadvantage: A Critical Analysis of National Pandemic Influenza Preparedness Plans’. Social Science and Medicine, 67(7): 1133–42. https://doi.org/10.1016/j.socscimed.2008.06.020
6. Tricco, A., E. Lillie, C. Soobiah, L. Perrier, and S. Straus (2012). ‘Impact of H1N1 on Socially Disadvantaged Populations: Systematic Review’. PLoS One, 7: 1–17. https://doi.org/10.1371/ journal.pone.0039437.
7. Quinn, S.C., and S. Kumar (2014). ‘Health Inequalities and Infectious Disease Epidemics: A Challenge for Global Health Security’. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 12(5): 263–73. https://doi.org/10.1089/bsp.2014.0032.
8. Mamelund, S., C. Shelley-Egan, and O. Rogeberg (2019). ‘The Association between Socioeconomic Status
   and Pandemic Influenza: Protocol for a Systematic Review and Meta-Analysis’. Systematic Reviews, 8(5):1–6. https://doi.org/10.1186/s13643-018-0931-2.
9. WHO (2020). WHO Timeline—COVID-19. Geneva: World Health Organization.
   https://www.who.int/news-room/detail/27-04-2020-who-timeline---covid-19.
10. Chen, J. T and Krieger, N (2020). Revealing the unequal burden of COVID-19 by income, race/ethnicity, and household crowding: US county vs ZIP code analyses. Harvard center for population and development studies, HCPDS Working Paper, Vol 19, No 1.
11. Samantha, A & Elizabeth, H (2018). Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity
12. Krieger N. (2001). A glossary for social epidemiology. J epidemiology Community Health, 55(10): 693–700. [PMC free article] [PubMed] [Google Scholar]
13. Brennan R., Ramirez, L.K., Baker, E.A, and Metzler, M. (2008). Promoting Health Equity, a Resource to Help Communities Address Social Determinants of Health. National Center for Chronic Disease Prevention and Health Promotion (U.S), Division of Adult Community Health
14. World Health Organization (2015). Health Equity. https://www.who.int/health-topics/health-equity
15. US Department of Health and Human Services. Healthy People 2020. http://www.healthypeople.gov/2020/default.aspx . [PubMed]
16. World Health Organization (2016) Social Determinants of Health. 2016. http://www.who.int/social_determinants/en .
17. Lynch J, Kaplan G. (2000) Socioeconomic position. In: Berkman LF, Kawachi I, eds. Social Epidemiology. New York, NY: Oxford University Press;13-35.
18. Wilkinson R, Marmot M. (2003). Social determinants of health: the solid facts. 2nd ed Copenhagen: WHO Regional Office for Europe. Copenhagen. [Google Scholar]
19. Singh, G.K. (2000) Socioeconomic and behavioral differences in health, morbidity, and mortality in Kansas: empirical data, models, and analyses. In: Tarlov AR, St. Peter RF, editors. The Society and Population Health Reader, Volume II: A State and Community Perspective. New York: The New Press; 2000. pp. 15–56. [Google Scholar]
20. Marandi, S. A. (2013). Social determinants of health. In: Handbook of public health. Hatami, et al. Tehran: Arjmand, Tehran, Vol. 3 pp: 2037–47. [Google Scholar]
21. Hosseini, S.M., Arab, M., Emamgholipour, S., Rashidian, A., Montazeri, A., Zaboli, R. (2017). Conceptual Models of Social Determinants of Health: A Narrative Review. Iran J Public Health. Apr;46(4):435-446. PMID: 28540259; PMCID: PMC5439032.
22. Healthy People 2020: Social Determinants of Health,” Office of Disease Prevention and Health Promotion, accessed April 25, 2018, https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
23. Marmot M, and Bell R. (2012) Fair society, healthy lives. Public Health. ;126 (Suppl 1): S4–10. [PubMed] [Google Scholar]
24. World Health Organization, Commission on Social Determinants of Health. Geneva: WHO (2008). Closing the gap in a generation: health equity through action on the social determinants of health. CSDH final report. [Google Scholar]
25. Braveman, P. A, Egerter, S.A, Woolf, S.H, Marks, J.S (2011). When do we know enough to recommend action on the social determinants of health? Am J Prev Med. 40(1 Suppl 1): S58–66. [PubMed] [Google Scholar]
26. Kelly, M.P, Morgan, A., Bonnefoy, J., Butt, J., Bergman, V. (2007). The social determinants of health: developing an evidence base for political action. Final report of the Measurement and Evidence Knowledge Network to the World Health Organization Commission on the Social Determinants of Health. [Google Scholar]
27. Anderson, L.M, Brownson, R.C, Fullilove M.T, Teutsch, S.M, Novick, L.F, Fielding J, et al. (2005). Evidence-based public health policy and practice: promises and limits. Am J Prev Med. 28(5 Suppl):226–30. [PubMed] [Google Scholar]
28. Fielding, J.E, Briss, P.A. (2006).  Promoting evidence-based public health policy: can we have better evidence and more action? Health Aff (Millwood), 25:969–78. [PubMed] [Google Scholar]
29. Glasgow, R.E, Emmons, K.M. (2007).  How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 28:413–433. [PubMed] [Google Scholar]
30. Health of Washington State Washington State Department of Health (undated). Social and Economic Determinants of Health, updated: 05/14/2013.
31. Ely DM, Driscoll AK. Infant Mortality in the United States (2018): Data from the Period Linked Birth/Infant Death File. National Vital Statistics Report; vol 69 no 7. Hyattsville, MD: National Center for Health Statistics. July 2020.
32. Schopfer, D.W. (2021). Rural health disparities in chronic heart disease. Prev Med. Nov;152(Pt 2):106782. doi: 10.1016/j.ypmed.2021.106782. Epub 2021 Sep 7. PMID: 34499971.
33. Arias, E., Tejada-Vera, B., Ahmad, F., Kochanek, K.D. (2020). Provisional life expectancy estimates for 2020. Vital Statistics Rapid Release; no 15. Hyattsville, MD: National Center for Health Statistics. July 2021.
34. Hood, C.M., Gennuso K.P., Swain G.R., et al. (2016). County Health Rankings: Relationships Between Determinant Factors and Health Outcomes in 45 States. American Journal of Preventive Medicine. February 2016; 50(2): 129-35. doi: 10.1016/j.amepre.2015.08.024.
35. Lawanson, O.M., Berleant, D., and Ajiferuke, O. (2025). Effect of Information Communication Technology and Immunization on Infant Mortality in Nigeria. World Journal of Advanced Research and Reviews
36. Lawanson, O.M., Abu-Halimeh, A., and Ajiferuke, O. (2025). Leveraging Advanced Technologies to Improve Telemedicine Delivery in Nigeria. World Journal of Advanced Research and Reviews
37. Marmot, M. G., and M. J. Shipley. "G, Rose. (undated). Inequalities in death-specific explanation of a general pattern."
    Lancet: 1003-1006.
38. Gregory, C. A., & Coleman-Jensen, A. (n.d.). Food insecurity, chronic disease, and health among working-age
    adults. http://www.ers.usda.gov/publications/pub-details/?pubid=84466.
39. Link, B.G, Northridge, M.E, Phelan, J.C, Ganz, M.L. (2000). Social epidemiology and the fundamental cause concept: on the structuring of effective cancer screens by socioeconomic status. Milbank Q. 76(3):375-402.
40. Marmot, M. G., Bosma, H., Hemingway, H., Brunner, E., & Stansfeld, S. (1997). Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet, 350, 235-239.
41. Andersen, R.M. (1968). Behavioral model of families’ use of health services. Research (series No. 25). Chicago, IL: Center for Health Administration Studies, University of Chicago.
42. Adenuga, A.H., Jack, C., Olagunju, K.O., Ashfield, A. (2020) Economic viability of adoption of automated oestrus detection technologies on dairy farms: A review. Animals 10, 1241.
43. Singirankabo, U.A.; Ertsen, M.W. (2020). Relations between Land Tenure Security and Agricultural Productivity: Exploring the Effect of Land Registration. Land 9: 138.
44. Irwin A, Valentine N, Brown C H, et al. (2006). The Commission on Social Determinants of Health: tackling the social roots of health inequities. PLoS Med, 3(6): e106. [PMC free article] [PubMed] [Google Scholar]
45. U.S. Department of Health and Human Services. Healthy People (2020). Social Determinants of Health. https://health.gov/healthypeople/objectives-and-data/social-determinants-health.
46. Fiscella, K., Franks, P., Gold, M.R., Clancy, C.M. (2000). Inequality in Quality: Addressing Socioeconomic, Racial and Ethnic Disparities in Health Care. Jama 283 (19), 2579-2584.
47. Nelson, A.R., and Smedley, B.D. (2003). Racial and Ethnic Disparities in Diagnosis and Treatment: A Review of the Evidence and Consideration of Causes. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care
48. Simeonova, P. (2009). Update on Carbon Nanotube Toxicity. Nanomedicine, 4 (4), 373 – 375
49. Kawachi, I., and B. Kennedy (2002). The Health of Nations: Why Inequality is Harmful to Your Health. New York: The New Press.
50. Wilkinson, R., and K. Pickett (2009). The Spirit Level: Why More Equal Societies Almost Always Do Better.
    London: Allen Lane.
51. Eichengreen, B. (2020). ‘Rage Against the Pandemic’. Project Syndicate, 8 June 2020. Available at: https://www.project-syndicate.org/commentary/covid19-racial-disparities-fuel-usa-protests-bybarry-eichengreen-2020-06 (accessed June 2020).
52. Alesina, A., E. Glaeser, and B. Sacerdote (2001). ‘Why Doesn’t the US Have a European-Style Welfare State?’. HIER Working Paper 1933. Cambridge, MA: Harvard University.
53. Rothstein, Bo. (2001). The Universal Welfare State as a Social Dilemma. Rationality and Society, 14:2: 190 – 214.
54. Link BG, Phelan J. (1995). Social conditions as fundamental causes of disease. J Health Soc Behav, Spec No: 80–94. [PubMed] [Google Scholar]
55. Marmot M. (2007). Achieving health equity: from root causes to fair outcomes. Lancet, 370(9593): 1153–63. [PubMed] [Google Scholar]
56. McGinnis JM, Williams-Russo P, Knickman J. 2002. The case for more active policy attention to health promotion. Health Affairs 21(2): 78-93.
57. Egerter S, Braveman P, Williams, D.R.(2011). The social determinants of health: coming of age. Annu Rev Public Health. 2011;32:381–98. [PubMed] [Google Scholar]
58. Jemal A, Thun MJ, Ward EE, Henley SJ, Cokkinides VE, Murray TE. Mortality from leading causes by education and race in the United States, 2001. Am J Prev Med. 2008;34:1–[PubMed] [Google Scholar]
59. Galea S, Tracy M, Hoggatt KJ, Dimaggio C, Karpati A. (2011) Estimated deaths attributable to social factors in the United States. Am J Public Health. 101:1456–65. [PMC free article] [PubMed] [Google Scholar]
60. Pamuk E, Makuc D, Heck K, Reuben C, Lochner K. Health, United States, 1998 with socioeconomic status and health chartbook. Hyattsville (MD): National Center for Health Statistics (US); 1998. [Google Scholar]
61. Nuru-Jeter A, Dominguez TP, Hammond WP, Leu J, Skaff M, Egerter S, et al. “It's the skin you're in”: African American women talk about their experiences of racism. An exploratory study to develop measures of racism for birth outcome studies. Matern Child Health J. 2009; 13:29–39. [PMC free article] [PubMed] [Google Scholar]
62. Williams DR, Mohammed SA. Discrimination and racial disparities in health: evidence and needed research. J Behav Med. 2009; 32:20–47. [PMC free article] [PubMed] [Google Scholar]
63. Chaix B, Rosvall M, Merlo J. Recent increase of neighborhood socioeconomic effects on ischemic heart disease mortality: A multilevel survival analysis of two large Swedish cohorts [published online ahead of print September 14 2006]. Am J Epidemiol.2007;165:122-126.
64. Weinstock M. The potential influence of maternal stress hormones on development and mental health in offspring. Brain Behav Immun. 2005:19(4) 296-308.
65. Barker DJ. The developmental origins of insulin resistance. Horm Res. 2005;64(Suppl 3):2-7.
66. Braveman PA, Cubbin C, Egerter S, Williams DR, Pamuk E. Socioeconomic disparities in health in the United States: what the patterns tell us. Am J Public Health. 2010;100(Suppl 1) : S186–96. [PMC free article] [PubMed] [Google Scholar]
67. Anda RF, Felitti VJ, Bremner JD, et al. The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiat Clin Neurosci. 2006;256(3):174-186.
68. Mackenbach, J. P., Stirbu, I., Roskam, A.-J. R., Schaap, M. M., Menvielle, G., Leinsalu, M., & Kunst, A. E. (2008). Socioeconomic inequalities in health in 22 European countries. New England Journal of Medicine, 358(23), 2468-2481.
69. Doorslaer E, Masseria C, Koolman X. Inequalities in access to medical care by income in developed countries. CMAJ. 2006;174(2):177-83. https://doi.org/10.1503/cmaj.050584.
70. Almeida APSC, Nunes BP, Duro SMS, Facchini LA. Socioeconomic determinants of access to health services among older adults: a systematic review. Rev Saude Publica. 2017; 51:50.
71. Gopal K. Singh, Mohammad Siahpush, and Michael D. Kogan, “Neighborhood Socioeconomic Conditions, Built
    Environments, and Childhood Obesity,” Health Affairs 29, no. 3 (March 2010):503-512
72. Hambleton IR, Clarke K, Broome HL. (2005). Historical and current predictors of self-reported health status among elderly persons in Barbados. Rev Panam Salud Publica, 17(5–6):342–52. [PubMed] [Google Scholar]
73. Fox, A., & Goldblatt, P. (1982). Longitudinal Study 1971-1975: Socio-demographic mortality differences. London: Her Majesty’s Stationary Office: Office of Population Censuses and Surveys.
74. Marmot, M. G., Shipley, M., & Rose, G. (1984). Inequalities in death – specific explanations of a general pattern? Lancet, 1003-1006.
75. Pearce, N., Marshall, S., & Borman, B. (1991). Undiminished social class mortality differences in New Zealand men. NZ Med J, 104, 153-156.
76. Sorlie, P., Eric, B., AND Jacob, B.K. (1995). “U.S. Mortality by Economic, Demographic and Social Characteristics: The National Longitudinal Mortality Study”. American Journal of Public Health, 85: 949 – 956.
77. Backlund, E., Sorlie, P. D., & Johnson, N. J. (1996). The shape of the relationship between income and mortality in the United States: Evidence from the National Longitudinal Mortality Study. Ann Epidemiology, 6, 12-20.
78. Davey Smith, G., Hart, C., Hole, D., MacKinnon, P., Gillis, C., Watt, G., Blane, D., & Hawthorne, V. (1998b). Education and occupational social class: which is the more important indicator of mortality risk? J Epidemiology Community Health, 52, 153-160.
79. Kaufman, J., Long, A., Liao, Y., Cooper, R., & McGee, D. (1998). The relation between income and mortality in U.S. Blacks and Whites. Epidemiology, 9, 147-155.
80. Howden-Chapman, P., & Tobias, M. (2000). Social Inequalities in Health: New Zealand 1999 (pp. 219). Wellington, NZ: Ministry of Health.
81. Cutler and Everett. (2010). Thinking outside the pillbox: Medication Adherence as a High Priority for Health Care Reform. New England Journal of Medicine. 362: 1553- 1555.
82. Simeonova, P. G. (2013). Prediction of Outcome in PolyTrauma Canine Patients. Acta Veterinaria (Beograd), Vol 63, No 2 – 3, 291- 301
83. Elo, I. T. (2009). Social class differentials in health and mortality: Patterns and explanations in comparative perspective. Annual Review of Sociology, 35, 553-572.
84. Robinette, J. W., Charles, S. T., & Gruenewald, T. L. (2017). Neighborhood Socioeconomic Status and Health: A Longitudinal Analysis. Journal of community health, 42(5), 865-871. doi:10.1007/s10900-017-0327-6.
85. Marmot, M.G, Bosma, H., Hemingway, H., Brunner, E., Stansfield, S. (2008). Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet. 350:235-239.
86. 86.Charles, C., Bainbridge, L., and Gilbert, J. (2009). The University of British Columbia Model of Interprofessional Education. Journal of Interprofessional Care, 23 (1, 1-2)
87. Case, A., Fertig, A., & Paxson, C. (2005). The lasting impact of childhood health and circumstance. Journal of Health Economics, 24(2), 365-389.
88. Reiss, F. (2013). Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Social Science & Medicine, 90, 24-31.
89. Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public Health Reports, 129(1_suppl2), 19-31.
90. Blazer, D. G., Landerman, L. R., Fillenbaum, G., & Horner, R. (1995). Health services access and use among older adults in North Carolina: urban vs rural residents. American Journal of Public Health, 85(10), 1384-1390.
91. Williams, D.R and Collins, C. (1995). U.S. Socioeconomic and racial differences in Health: Patterns and Explanations. Annual Review of Sociology, 21, 349 – 386.
92. Brown, T. H. (2018). Racial Stratification, Immigration and Health Inequality: A life course-intersectional approach. Social Forces, 96 (4): 1507 – 1540.
93. Mackenbach, J. P., Cavelaars, A., Kunst, A. E., & Groenhof, F. (2000). Socioeconomic inequalities in cardiovascular disease mortality. An international study. European heart journal, 21(14), 1141-1151.
94. Marmot, M. (2004). The status syndrome: how social standing affects our health and longevity. London: Bloomsbury.
95. Cambois, E., Robine, J.-M., & Hayward, M. D. (2001). Social inequalities in disability-free life expectancy in the French male population, 1980–1991. Demography, 38(4), 513-524.
96. Jama, K. (2022).  "Socioeconomic Determinants of Antibiotic Resistance" Theses and Graduate Projects. 1258. https://idun.augsburg.edu/etd/1258.
97. Wilkinson RG. The Impact of Inequality, New York, NY: The New York Press; 2005.
98. Chaix, B., Rosvall, M., and Merlo, J. (2007). Assessment of the Magnitude of Geographical Variations and Socioeconomic Contextual Effects on Ischemic Heart Disease Mortality: A Multilevel Survival Analysis of a Large Swedish Cohort. Journal of Epidemiology & Community Health, 61 (4: 349 -355)
99. National Research Council and Institute of Medicine. U.S. Health in International Perspective: Shorter Lives, Poorer Health. Panel on Understanding Cross-National Health Differences Among High-Income Countries. Woolf SH, Aron L, eds. Committee on Population, Division of Behavioral and Social Sciences and Education, and Board on Population Health and Public Practice, Institute of Medicine. Washington, DC: The National Academies Press; 2013.
100. Office of Financial Management. The Distribution of Income, Wealth, and Taxes Across Washington Households. Olympia, WA: Office of Financial Management; 2012. http://www.ofm.wa.gov/reports/income_wealth_report.pdf. Accessed May 15, 2013.
101. Kuh, D, Hardy, R, Langenberg C, Richards M, Wadsworth, M.E (2002). Mortality in adults aged 26–54 years related to socioeconomic conditions in childhood and adulthood: post war birth cohort study. BMJ.;325:1076–80. [PMC free article] [PubMed] [Google Scholar]
102. Lawlor DA, Batty GD, Morton SM, Clark H, Macintyre S, Leon, D.A ( 2005). Childhood socioeconomic position, educational attainment, and adult cardiovascular risk factors: the Aberdeen children of the 1950s cohort study. Am J Public Health.,95:1245–51. [PMC free article] [PubMed] [Google Scholar]
103. Melchior M, Moffitt TE, Milne BJ, Poulton R, Caspi A. Why do children from socioeconomically disadvantaged families suffer from poor health when they reach adulthood? A life-course study. Am J Epidemiology. 2007; 166:966–74. [PMC free article] [PubMed] [Google Scholar]
104. The White House (January 20, 2021). Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities Through the Federal Government.
     https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/20/executive-order-advancing-racialequity-and-support-for-underserved-communities-through-the-federal-government/
105. Marmot M. Inequalities in Health. New England Journal of Medicine, 2001; 345:134-136.
106. Chandola T, Bartley M, Wiggins R and Schofield P. Social inequalities in health by individual and household measurements of social position in a cohort of healthy people. J Epidemiology Community Health, 2003; 57:56-62.
107. African Health and Development Communications Limited (AHNDCL) (2010). Improving Access to Healthcare in Nigeria: Challenges and Opportunities, Lagos, Nigeria, AHNDCL Publications.