Social determinants of health are associated with physical therapy use: a systematic review

Review written by Dr Christina Le info

Key Points

  1. Predisposing social determinants of health (SDH) factors of female sex, white race, higher education, urban environment, and employment were associated with a higher likelihood of physiotherapy use.
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Did you know that one in three people live with a health condition that could benefit from rehabilitation? This fact helped inspire the World Health Organization (WHO) to launch their Rehabilitation 2030 initiative that emphasizes accessibility to rehabilitation for all populations (1).

To improve accessibility, we must better understand what social determinants of health (SDH) may affect who seeks rehabilitation. The WHO defines SDH as the conditions in which people are born, grow, work, live, and age.

With an aging population and growing number of people living with chronic conditions, identifying SDH that facilitate or impede access to rehabilitation is crucial. Therefore, the objective of this systematic review was to identify SDH and evaluate the association between SDH and use of physiotherapy.

One in three people live with a health condition that could benefit from rehabilitation.
Assessing or screening for social determinants of health is recommended to identify what factors may serve as facilitators or barriers to your patient’s recovery.


Eligible studies examined SDH in the context of adults (≥ 18 years) who perceived themselves to have a health problem and independently sought physiotherapy services. SDH was defined as sex/gender, race/ethnicity, education, environment, employment, socioeconomic status, insurance, transportation, and early

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