社会健康决定因素（SDH）被报告为导致健康不平等的相关因素。我们旨在评估观察性研究中的临床数据，评估SDH对血液恶性肿瘤患者结局的影响。因此，我们在2021年9月1日进行了6个数据库的系统回顾，使成对的评审人员独立筛选研究并纳入41个研究的数据。我们使用Joanna Briggs Institute评估工具评估偏倚风险，并使用描述性综合分析了数据。最常研究的SDH领域是医疗保健接入与质量（54.3%）和经济稳定性（25.6%）；其他研究的领域包括教育（19%）和社会与社区背景（7.8%）。我们确定了五个明显影响生存的变量的强有力证据：缺乏健康保险覆盖或拥有医药保险；在非学术机构接受癌症治疗；低家庭收入；低教育水平；以及未婚。相反，关于前往治疗中心的路程对结果的影响的报告是矛盾的。其他研究的SDH领域包括设施规模、提供者专业知识、贫困和就业率。我们发现文献中缺乏有关交通、债务、高等教育、饮食、社会融入、环境因素或压力的数据。我们的结果强调了社会、财务和医疗保健壁垒作为互相关联变量的复杂性质。因此，血液恶性肿瘤的管理需要共同努力将SDH纳入临床护理、研究和公共卫生政策中，以识别和解决以患者为基础的障碍，以增强结果的公平性（PROSPERO CRD42022346854）。版权所有©2023年美国血液学会。

Social Determinants of Health (SDH) have been reported as relevant factors responsible for health inequity. We sought to assess clinical data from observational studies evaluating the impact of SDH on the outcomes of patients with hematologic malignancies. Thus, we performed a systematic review in 6 databases on September 1, 2021, in which paired reviewers independently screened studies and included data from 41 studies. We assessed the risk of bias by the Joanna Briggs Institute appraisal tools and analyzed the data using a descriptive synthesis. The most common SDH domains explored were healthcare access and quality (54.3%) and economic stability (25.6%); others investigated were education (19%) and social and community context (7.8%). We identified strong evidence of five variables significantly affecting survival: lack of health insurance coverage or having Medicare or Medicaid insurance; receiving cancer treatment at a non-academic facility; low household income; low education level; and being unmarried. In contrast, the reports on the effect of distance traveled to the treatment center are contradictory. Other SDH examined were facility volume, provider expertise, poverty, and employment rates. We identified lack of data in the literature in terms of transportation, debt, higher education, diet, social integration, environmental factors, or stress. Our results underscore the complex nature of the social, financial, and healthcare barriers as intercorrelated variables. Therefore, the management of hematologic malignancies needs concerted efforts into incorporating SDH into clinical care, research, and public health policies, identifying and addressing the barriers at a patient-based level to enhance outcome equity (PROSPERO CRD42022346854).Copyright © 2023 American Society of Hematology.