Key aspects to address include:
- Understanding Health Equity: The study operates within definitions of health equity, noting the CDC’s definition as “the state in which everyone has a fair and just opportunity to attain their highest level of health”. This emphasizes addressing social determinants of health (SDH) and eliminating disparities for historically marginalized or disadvantaged groups due to factors like economic status, race, or geographic location. The World Health Organization (WHO) also defines HE as the absence of unfair, preventable, or amendable health differences among population groups.
- Study Methodology: The authors employed a bibliometric approach using co-word analysis to map HE studies. This method involves identifying relevant keywords, analyzing their co-occurrences to form conceptual clusters, and visualizing relationships between these clusters to understand thematic evolution. Data was systematically searched across four leading databases: Scopus, Web of Science, ScienceDirect, and PubMed. The analysis was conducted independently for two distinct time intervals to account for the impact of the COVID-19 pandemic: the period up to the end of 2019 (pre-COVID-19) and the period from the beginning of 2020 to the end of 2023 (post-COVID-19). VOSviewer software was used for data analysis.
- Research Growth and Trends: The study revealed a significant increase in research focused on HE in recent years, with the earliest publications appearing in 1975. The compound annual growth rate (CAGR) of HE documents varied by database, with ScienceDirect showing the highest growth at 0.453, followed by Web of Science at 0.317, Scopus at 0.173, and PubMed at 0.157.
- Geographic Contributions: The United States leads in the volume of HE publications, followed by Canada, the United Kingdom, and Australia. Developed nations contribute the majority of research, potentially due to factors like research funding, the number of researchers, and access to publisher networks. However, the US continues to face considerable racial inequalities in health coverage, which may influence the correlation between HE keywords in “race and ethnicity” and the US.
- Shifting Topic Clusters:
- Before the COVID-19 pandemic (up to 2019), the predominant topic clusters were “Health care,” “Health economics,” “Race and ethnicity,” “Social determinants of health,” and “Age and gender”. This indicates an early focus on fundamental determinants of equity and inequity in health.
- Following the onset of the COVID-19 pandemic (2020–2023), the research focus shifted, resulting in six distinct topic clusters: “Health workforce,” “Risk factors,” “Maternal and child health,” “COVID-19,” “Cancer,” and “Mental health”. This shift highlights an increased emphasis on the burden of different diseases and their associated risk factors.
- Key Emerging Topics:
- The study identified “Artificial intelligence,” “Racial disparity,” and “Machine learning” as three significant emerging topics in HE in the post-COVID-19 period, along with “COVID-19” and “Electronic health record”. These areas represent novel research domains, especially for low- and middle-income countries.
- The authors emphasize that while AI offers opportunities in healthcare, it could also deepen existing health disparities if equity considerations are not prioritized during its development and application.
- The emergence of “Racial disparity” as a key topic underscores the significant impact of structural racism on HE and the need to combat it to promote equitable health opportunities.
- The COVID-19 pandemic itself intensified concerns about escalating health inequities, driven by differences in exposure, transmission, susceptibility, and treatment linked to broader structural issues.
This study’s findings are crucial for both researchers and science policymakers, offering essential insights into the trends and domains within health equity research.
APA Reference:
Sarikhani, Y., Kalavani, A., & Najibi, S. M. (2025). Scientific Mapping of Global Research on Health Equity by 2023: A Bibliometric Study. Health Science Reports.
