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Helping all people reach their full health potential is the goal of achieving health equity. Many health inequities linked to race are due to structural barriers such as lack of access to appropriate health and social services, as well as environmental and occupational risk factors that may vary by socioeconomic status. By taking racial or ethnic categorizations into account, without added context, however, health equity research may mistakenly imply that health inequities are caused by biological differences between ethnic groups.

To promote more nuanced health equity research, PCORI commissioned a rapid review of an evidence map of social needs interventions, such as employment and child care assistance, to improve health outcomes. Over 25 years of research on social needs interventions, from 1995 through 2021, was examined to determine whether social drivers of racial health inequity were identified and evaluated.

The review found that of 152 studies conducted in multiracial or multiethnic populations, 44 studies included race or ethnicity in their analyses. Of these, only four studies (9 percent) were considered what the research team described as conceptually thoughtful, meaning the interplay among race, racism and other social drivers of health was taken into consideration.

Twenty-one studies (14 percent) were considered analytically informative and actually reported whether intervention outcomes differed by race or ethnicity of participants. Seven of these found differences in outcomes by race or ethnicity. Of these seven studies, four demonstrated that the intervention was associated with improved outcomes for minoritized racial or ethnic groups.

Multiple historic and structural factors must be addressed to achieve health equity. Unfortunately, most studies included in this review did not meaningfully consider systemic barriers to health. The research team concluded that a conceptually thoughtful framework—one that takes racism and other social factors into account—should be used when developing and evaluating future social needs interventions designed to promote health equity.

The findings of the review were published in JAMA Network Open.