Understanding Social Determinants of Health and Why They Matter in Clinical Research
Clinical research has traditionally focused almost entirely on study eligibility, but as the push for more inclusive research continues to grow, it has become increasingly apparent that eligibility alone is not sufficient. To truly expand access and improve representation in trials, sponsors must also consider the broader context of participant populations, known as social determinants of health.
What Are Social Determinants of Health?
Social determinants of health (SDOH) are the non-medical factors that influence health outcomes. They are defined by the World Health Organization (WHO) as “the conditions in which people are born, grow, live, work, and age”, and they affect everything from access to care to the ability to participate in research. Approximately 80-90% of an individual’s health is determined by SDOH, according to the National Academy of Medicine.
The Office of Disease Prevention and Health Promotion groups SDOH into five different categories:
- Economic Stability
- Education Access and Quality
- Healthcare Access and Quality
- Neighborhood and Built Environment
- Social and Community Context
The Link Between SDOH and Clinical Research
Social determinants don’t just affect health, they affect research. A potential study participant may be eligible for a study, but unable to take time off work, find childcare, or travel to a research site. A 2021 CISCRP global study of over 11,000 participants found that 25% of respondents traveled over an hour one way for every site visit, and 44% of respondents cited traveling to the study site as the most burdensome part of participating in a trial. In other cases, cultural mistrust or lack of community outreach may prevent trial participation. Ignoring these factors means excluding entire groups of people, particularly those in rural areas or underrepresented populations. It also means that data collected during a study may not be fully representative of the real-world patient population.
How Community-Based Research Addresses SDOH
Community-based research models expand the reach of clinical research by bringing trials directly into local communities through decentralized elements like mobile visits and community research sites. By meeting patients where they are, community-based models help sponsors address some of the most common barriers related to SDOH, including:
- Transportation and time constraints
- Childcare or caregiver responsibilities
- Limited mobility or chronic conditions
- Geographic limitations
These solutions improve comfort and convenience for patients, which can lead to improved protocol adherence and data quality.
Moving Forward: Making Equity Actionable
As the industry continues to emphasize the importance of inclusive research and sponsors aim to reach more representative populations, incorporating patient-centric solutions early in trial design and operational strategies is key.
Understanding SDOH isn’t just about identifying potential barriers to participation, it’s about building solutions that benefit both sponsors and patients alike. Community-based research solutions have the power to redefine how research is conducted to support better health outcomes for all.
