Impact of socioeconomic determinants on outcomes of eight select conditions for which self-care is a modality for prevention and treatment: a scoping review

We conducted a scoping review of peer-reviewed literature published between January 1, 1990 and October 31, 2021, to identify socioeconomic determinants that contribute to higher burden and adverse outcomes in diseases for which self-care is an important modality of treatment and prevention. We identified these diseases using over-the-counter medicines sales data sourced from IQVIA. We then searched Ovid Medline, PubMed, and EMBASE databases for articles published in English using inclusion/exclusion criteria related to populations, interventions, outcomes and study designs. We analyzed articles covering 42 diseases that qualified as cardiovascular disorders (219 studies, which included ischemic heart disease, myocardial infarction, stroke, and related risk factors such as hypertension, dyslipidemia and atrial fibrillation), nutritional disorders (66 studies, which included malnutrition, including undernutrition and micronutrient deficiencies, and anemia), digestive disorders (40 studies, which included gastroesophageal reflux disorder, inflammatory bowel disease, and dyspepsia), allergy disorders (40 studies, which included asthma and allergic rhinitis), pain disorders (14 studies, which included lower back pain, knee pain, generalized musculoskeletal pain and headaches), dermatological disorders (23 studies, which included atopic dermatitis [eczema], occupational dermatosis, and facial dermatitis), respiratory disorders (11 studies, which included chronic cough, pneumonia, chronic bronchitis, wheezing, and influenza), and gynecological disorders (29 studies, which included bacterial vaginosis and trichomoniasis vaginosis). We found that lifestyle factors were the most commonly reported risk factors, and residential segregation, education, and income were the most commonly reported socioeconomic determinants. A closer analysis of income within each disorder revealed that it is more commonly associated with health conditions that are self-limiting. Although we did not find any discernible relationship between commonly reported socioeconomic factors and the prevalence of self-medication for the health conditions considered, income plays a more important role in the burden and outcomes of conditions that require more self-care compared to those that require less self-care.