Table 1 Summary of Social Determinants of Health (SDH) and their Impact on Mpox Outcomes.
SDH factor | Documented impact on Mpox | Empirical evidence/mechanism |
|---|---|---|
Race or ethnicity | Disproportionately higher incidence rates among racial/ethnic minority groups (e.g., Black and Hispanic males) despite vaccination efforts. | Systemic barriers, racism, homophobia, xenophobia, and discrimination create barriers to prevention, information access, and vaccine uptake. |
Socioeconomic status (eg, income, education) | Lower education levels and poverty are associated with higher health anxiety and lower vaccine perception/intention. | Limited access to quality healthcare, information dissemination gaps, and financial stress impact health-seeking behaviors and mental health. |
Geographic location (urban or rural) | Challenges in accessing care and higher rates of mental health issues in rural areas due to limited services and stigma. | Limited access to services, discrimination, and societal stigma create barriers to care. |
Discrimination | Increased health anxiety, avoidance of care, and mental health issues (e.g., depression and anxiety). | Fear of discrimination leads to delayed diagnoses, underreporting, and non-adherence to preventive measures. |
Social networks | Influence transmission patterns (e.g., sexual networks) and can either facilitate or hinder prevention efforts. | Homophily in sexual partnership selection can drive disparities. Social capital can support prevention or foster subcultures challenging norms. |
Stigma | Hinders prevention strategies, discourages testing, delays treatment, leads to concealment of symptoms, and exacerbates mental health issues. | Fear of social repercussions, discrimination, and psychological distress leads individuals to avoid medical care and adherence. |
