RT journal article T1 Drivers of health polarization during the COVID-19 pandemic: A systematic review A1 Camacho García, María A1 Serrano-Macias, M. A1 Ortega Martín, María Esther A1 Álvarez Gálvez, Javier A2 Economía General K1 COVID-19 pandemic K1 Public Health K1 Social Media K1 Socioeconomic Factors AB Health polarization has emerged as a critical factor shaping public health attitudes and behaviors, particularly during crises such as the COVID-19 pandemic. This study provides a systematic review of the key determinants driving health polarization, highlighting the complex interplay of political, social, economic, and psychological factors. By synthesizing findings from 90 studies, we identify six primary drivers: political ideology and partisanship, misinformation and disinformation, social media structures and dynamics, trust in health institutions and professionals, risk and public health perceptions, and socioeconomic factors. Our analysis reveals how these determinants reinforce societal divisions, exacerbate health inequalities, and influence adherence to public health measures. Furthermore, we discuss the implications of these findings for designing effective interventions that address the root causes of health polarization. Understanding the mechanisms underlying these divisions is essential for mitigating their negative impact on public health and fostering more cohesive, evidence-based health communication strategies. PB American Association for the Advancement of Science SN 2375-2548 YR 2025 FD 2025 LK http://hdl.handle.net/10498/39553 UL http://hdl.handle.net/10498/39553 LA eng DS Repositorio Institucional de la Universidad de Cádiz RD 08-nov-2026