Damani, Tasleem ORCID: https://orcid.org/0009-0007-8058-2168, Clark, Andrew and Osman, Muhammad ORCID: https://orcid.org/0000-0003-3818-9729 (2026) Social determinants of health and antimicrobial resistance in the UK: a scoping review. BMJ Open, 16:e114037. ISSN 2044-6055 (Online) (doi:10.1136/bmjopen-2025-114037)

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Abstract

Objective Antimicrobial resistance (AMR) is a global public health threat, responsible for an estimated 35 200 bacterial resistance attributable deaths in the UK in 2019. Social determinants of health (SDoH) drive inequities that influence health outcomes. We aimed to conduct a scoping review of the evidence of the association between the SDoH and AMR in the UK.
Design A scoping review was conducted using search terms related to SDoH and AMR across multiple databases, supplemented by manual searches. This followed Arksey and O’Malley’s framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline.
Data sources A systematic search was conducted across SCOPUS, PubMed, Academic Search Premier, AMED, APA PsycArticles, APA PsycInfo, CINAHL Plus with Full Text, Humanities International and Web of Science.
Eligibility criteria Primary UK-based literature exploring SDoH in relation to infectious disease syndromes requiring antimicrobial therapy and reporting AMR were included. Studies from January 2020 onwards, published in English, across all populations were considered. Non-UK studies, reviews, studies not addressing AMR, laboratory-based research and non-human health contexts were excluded.
Data extraction and synthesis Records were screened against eligibility criteria with reasons for exclusion documented. Data were charted against a customised form capturing study characteristics and key findings. Findings were thematically categorised to generate narrative synthesis.

Results 21 outputs met the inclusion criteria. Older females and those from lower socioeconomic groups showed higher antibiotic use and resistance. Migrant populations were vulnerable to AMR through poor living conditions and limited healthcare access. Misconceptions about AMR were common among younger and socioeconomically disadvantaged populations. Prescribing practices reflected patient expectations, systemic pressures and healthcare gaps, while fragmentation between primary and secondary care limited coordinated management and policy implementation.
Conclusion AMR in the UK is driven by social, economic and systemic factors, placing vulnerable groups at heightened risk. Sustainable and equitable control requires integrating SDoH through targeted interventions, public engagement and inclusive policymaking to meet national and global targets.

Item Type:	Article
Uncontrolled Keywords:	antimicrobial resistance, social determinants of health, UK
Subjects:	H Social Sciences > H Social Sciences (General) Q Science > Q Science (General) R Medicine > R Medicine (General)
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	15 Jul 2026 14:17
URI:	https://gala.gre.ac.uk/id/eprint/53959

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