Emergency department (ED) utilization for non-urgent conditions remains a persistent challenge in healthcare systems, contributing to overcrowding, increased healthcare costs, and strain on emergency services. These pressures may also reduce efficiency and quality of care within emergency settings. Growing evidence suggests that social determinants of health (SDOH), including socioeconomic status, housing instability, lower educational attainment, and insurance coverage, play an important role in shaping patterns of healthcare utilization. However, the role of social and structural factors in non-urgent emergency department use remains complex and not fully understood. This narrative review aimed to synthesize current evidence evaluating how social determinants of health contribute to patterns of non-urgent emergency department utilization. Relevant literature was identified through searches of PubMed and Google Scholar using the terms “social determinants of health,” and “non-urgent emergency department use.” Peer-reviewed studies examining the relationship between SDOH and non-urgent ED utilization were included, while studies focused on pediatric or emergent ED utilization were excluded. Across studies, several SDOH were associated with increased reliance on the emergency department for non-urgent conditions. Socioeconomic disadvantage, housing instability, lower educational attainment, and limited insurance coverage were frequently associated with higher rates of ED visits classified as non-urgent. These findings suggest that non-urgent ED use often reflects barriers to primary care access and broader structural challenges within the healthcare system rather than individual misuse of emergency services. This highlights the need for interventions targeting upstream barriers to care that may help reduce reliance on emergency services. However, variations in study populations, definitions of non-urgent ED use, and measurement of SDOH may limit comparability of findings across studies. Despite these limitations, addressing social and structural determinants may help reduce non-urgent emergency department utilization and improve patient care outcomes.
