Associations between Social Determinants of Health and Pregnancy among Young People: A Systematic Review of Research Published during the Past 25 Years

Abstract

Objective. Major health disparities exist in pregnancy among young people. Although social determinant of health (SDH) approaches in interventions are promoted to reduce these disparities, little research exists that synthesizes empirical links between SDHs and pregnancy among young people. This systematic literature review utilized the Healthy People 2020 SDH framework to analyze and synthesize the empirical associations between SDHs and pregnancy among young people. Methods. We included studies that were published in the past 25 years from PubMed, PsycINFO®, and Academic Search™ Premier databases. Twenty-two studies met all inclusion criteria and, following the Matrix Method, were assessed for methodological quality and empirical links between determinant areas and pregnancy. Results. Seventeen studies reported an empirical association between at least one SDH and pregnancy among young people. Areas most represented were poverty and family structure. No studies examined the relationship between pregnancies among young people and quality of housing, access to healthy foods, access to health-care services and primary care, health technology, social cohesion, perceptions of discrimination/equity, access to employment, employment status, school policies that support health promotion, safe school environments, or higher education enrollment. Conclusion. This research indicates a need to expand the range of SDHs that are analyzed with pregnancy among young people and to focus interventions on areas that have been determined to have an empirical link with pregnancy.