Incorporating Social Determinants of Health in Electronic Health Records: Qualitative Study of Current Practices Among Top Vendors
"Vendors indicate they are actively developing products to facilitate the collection and use of SDH data for their clients and are seeking solutions to data standardization and interoperability challenges through internal product decisions and collaboration with policymakers. Due to a lack of policy standards around SDH data, product-specific decisions may end up being de facto policies given the market shares of particular vendors. However, commercial vendors appear ready to collaboratively discuss policy solutions such as standards or guidelines with each other, health care systems, and government agencies in order to further promote integration of SDH data into the standard of care for all health systems."
Social inequality, health behaviour determinants and health behaviour: A Systematic Review
"This systematic review will summarise the current of evidence on indirect or moderating effects of social inequality in the relationship between determinants of health behaviour and health behaviour. The results of this review have substantial relevance for theory development, theory refinement and development of equity-focused interventions."
Consider the root of the problem: increasing trainee skills at assessing and addressing social determinants of health
"Trainees were able to utilize a lower-stakes interaction with patient-actors to raise awareness regarding a patient’s sensitive needs and to organize care surrounding these patient-centered concerns."
Assessing the social determinants of health in Tourette Syndrome
"Health care disparities appear to be present in TS patients, including delayed diagnoses in females compared to males, and higher rates of comorbid ADHD in Hispanic compared to non-Hispanic individuals. These analyses will be expanded to 3000 individuals in the TAAICG database. Further understanding of the pathways to disparities must be understood to eliminate potential inequities."
Heart failure and social determinants of health in Thailand: An integrative review
"As the burden of heart failure increases in Thailand and other emerging economies, developing culturally appropriate, affordable and acceptable models of intervention considering social determinants of health is necessary."
Inequalities in the social determinants of health and Chagas disease transmission risk in indigenous and creole households in the Argentine Chaco
"This synthetic approach to assess socio-economic related inequalities in transmission risk provides key information to guide targeted vector control actions, case detection and treatment of Chagas disease, towards sustainability of interventions and greater reduction of health inequalities."
Teaching the Social Determinants of Health in Undergraduate Medical Education: a Scoping Review
"The abundance of initial articles screened highlights the growing interest in SDH in medical education. The small number of selected articles with sufficient detail for abstraction demonstrates limited SDH curricular dissemination. A lack of accepted tools or practices that limit development of robust learner or program evaluation was noted. Future research should focus on identifying and evaluating effective instructional and assessment methodologies to address this gap, exploring additional innovative teaching frameworks, and examining the specific contexts and characteristics of marginalized and underserved populations and their coverage in medical education."
Impact of Race and Ethnicity on the Clinical and Angiographic Characteristics, Social Determinants of Health, and 1-Year Outcomes After Everolimus-Eluting Coronary Stent Procedures in Women
"Race and ethnicity confer heterogeneity in women undergoing everolimus-eluting stent implantation. Despite more comorbidities and less favorable social determinants of health, AA and HL women have similar 1-year major adverse cardiac events to white women, although AA women seem to have a higher risk of 1-year myocardial infarction."
Addressing Social Determinants of Health: Challenges and Opportunities in a Value-Based Model
"Two forces are reverberating within the US health care system. The first is the medical system’s recognition that addressing a patient’s social circumstances is necessary to promote health and prevent disease. Pediatrics has long espoused the strong influence of family and social conditions on children’s wellbeing. The second force is movement away from fee-for-service reimbursement to a value-based model in which payment is based on quality measures and health outcomes. "
The Social Determinants of Health for Asthmatic Children in Low-Income Communities
"Racial and socioeconomic disparities persist among pediatric asthmatic patients presenting to the emergency department. In addition to addressing asthma-related complications, future nursing interventions for asthma care should focus on social determinants of health which include, but not limited to: current living conditions, emotional & psychosocial factors, school days, missed work or daily activities. This self-assessment questionnaire should provide a simple way to address the limitations identified in this review."
A public health perspective on using electronic health records to address social determinants of health: The potential for a national system of local community health records in the United States
"An EHR-derived CHR – relative to current survey-based assessments used by public health agencies in the United States and other countries – could dramatically increase the scope, quality, and timeliness of data available for planning interventions targeted at SDOH factors at both the consumer and small-area levels. EHR-derived CHRs, if assembled across neighborhoods, could also offer a significant value to the society by providing population-level SDOH data across various regions and eventually nationwide.
Exploring consensus across sectors for measuring the social determinants of health
"This study revealed that while numerous SDOH measurement resources exist, relatively few are tools for measuring the SDOH. Although the SDOH categories being measured could be readily summarized across tools, there was wide variation in the particular SDOH categories included in each tool. Finally, remarkably little consensus exists for the specific indicators used to measure SDOH categories. While complete consensus across tools may not be possible, learning how different sectors measure SDOH and more systematically aligning SDOH categories and indicators being measured will enable greater collaboration and deepen the impacts of place-based interventions to improve community health and well-being."
Addressing Social Determinants of Health: Case Studies from Epic's Population Health Steering Board
"More than two thirds of health care organizations report that they now assess populations for SDOH as part of ongoing care management. The 2 most frequent interventions cited are referral to community service agencies (78.1%) and help with navigation of services (76.6%). Notwithstanding this self-reported activity, many health care organizations are still early in their journey to build an effective overall system for SDOH screening, intervention, and measurement."
Capturing Social Health Data in Electronic Systems
"The most common social health data domains were neighborhood and community compositional characteristics. Social health data were rarely found in electronic health records. When these data were captured, they were often manually captured in a structured format."
Cross-Cutting Themes to Advance the Science of Minority Health and Health Disparities
"Advancing the science of minority health and health disparities is vital for the health of the nation. The US population demographics are changing dramatically. By 2055, there will be no single racial or ethnic majority. Thus, it is important for the science both to continue to address socially disadvantaged populations historically underrepresented in research, and to anticipate the increasing diversity."
Patterns of social determinants of health associated with drug use among women living with HIV in Canada: a latent class analysis
"Social determinants of health vulnerabilities are associated with greater likelihood of drug use, underscoring the significance of addressing interlinked social determinants and drug use through the course of HIV care and treatment."
Social determinants and non-communicable diseases: time for integrated action
"The argument for integrated action rests on evidence compiled by the World Health Organization Commission on Social Determinants of Health. Social determinants are responsible for the pattern of distribution of disability and mortality from NCDs.7 Simply stated, social determinants encompass the “causes of the causes” of health inequality: the unequal conditions in which people are born, grow, live, work, and age; and the inequities in power, money, and resources that give rise to them.7 These unequal conditions depend on dimensions of social stratification, including socioeconomic status, gender, ethnicity, and disability."
Social Needs and Health-Related Outcomes Among Medicaid Beneficiaries
"Results add to the evidence about the relationship between unmet social needs and health. Interventions to help meet social needs may help low-income people improve both their economic situations and their health."
Using unfolding case studies to better prepare the public health nutrition workforce to address the social determinants of health
"This learning activity challenged students and supported deep learning about possible solutions. It may also be useful at a graduate level and for continuous education of nutritionists and/or dietitians to empower the workforce to address the social determinants of health, rather than just acknowledging them as a set of barriers that prevent people and communities from achieving optimal health. Further work is required to investigate how unfolding case studies in curricula shape preparedness for practice of public health nutrition."
Social Determinants of Health and Health Disparities Among Immigrants and their Children
"Health care providers have the responsibility of addressing the social determinants of health that affect the physical and mental health of this vulnerable population. Without new federal health reform or a pathway to citizenship, undocumented immigrants will continue to face health disparities. Health care providers at community health centers, clinics, and public hospitals will have to continue building creative strategies to provide necessary comprehensive care for undocumented patients."
Maternal Social and Economic Factors and Infant Morbidity, Mortality, and Congenital Anomaly
"This study found that newborn and postneonatal hospital readmissions are inversely associated with geography. Additionally, social context, including maternal history of child abuse, is associated with infant postneonatal hospital readmissions. Geography and education are associated with infant mortality. Income was not associated with infant mortality or morbidity following adjustment for social support. Interestingly, congenital anomaly rates are 1.2 times more common among 2 parent families and male infants. Understanding associations between infant health and maternal social and economic factors may contribute to interventions and policies to improve health equity."
Social Determinants of Health Training in U.S. Primary Care Residency Programs
"The authors identified wide variation in curriculum development, implementation, and evaluation. They highlight curricula that considered community and resident needs, used conceptual frameworks or engaged multiple stakeholders to select content, used multiple delivery methods, and focused evaluation on changes in skills or behaviors. This review highlights the need not only for systematic, standardized approaches to developing and delivering SDH curricula but also for developing rigorous evaluation of the curricula, particularly effects on resident behavior."
Integrating Latina/o ethnic determinants of health in research to promote population health and reduce health disparities.
"The expected dividends of the proposed Latina/o ethnic determinants of health research agenda amount to the generation of research that clarifies the role of ethnicity in SDOH and population health processes that are highly influential in ongoing regional and national health agendas."
Cross‐country evidence on the social determinants of the post‐socialist mortality crisis in Europe: a review and performance‐based hierarchy of variables
"The literature identifies inequality, welfare payments, religious composition, democracy, economic performance and unemployment as the leading factors that have a significant influence on mortality outcomes. Existing cross‐country studies fail to establish a definitive connection between mortality and diets, drinking patterns, liberalisation, trust, health expenditure and war. We also point out that the level of analysis is not a neutral methodological choice but might influence the results themselves."
Advancing Health Services Research to Eliminate Health Care Disparities
"Findings from health services research highlight continuing health care disparities in the United States, especially in the areas of access to health care and quality of care. Although attention to health care disparities has increased, considerable knowledge gaps still exist. A better understanding of how cultural, behavioral, and health system factors converge and contribute to unequal access and differential care is needed."
Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: A systematic review and meta‐analysis
"Social determinants of health contribute to the risk of adverse pregnancy outcomes in adolescent mothers. African American race, rural residence, inadequate education, and low SES are markers for poor pregnancy outcomes in adolescent mothers. Further research needs to be done to understand the underlying causal pathways to inequalities in adolescent pregnancy outcomes."
Revisiting the social determinants of health agenda from the global South
"It is argued that the debates shaping the equity in health agenda do not merely reflect conceptual differences, but essentially different ethical-political proposals that define the way health inequities are understood and proposed to be transformed. While the health equity agenda probably also gained momentum due to the broad political alliance it managed to consolidate, it is necessary to make differences explicit as this allows for an increase in the breadth and specificity of the debate, facilitating the recognition of contextually relevant proposals towards the reduction of health inequities."
The time is now: Fostering relationship-centered discussions about patients’ social determinants of health
"This discussion piece uses a relationship-centered framework to offer several evidence-based recommendations for health care systems on how to help their workforce respectfully listen and collaborate with patients to address SDOH. Additional research into patient and provider perceptions of relationship-centered communication surrounding screening and referral practices can help further adapt and refine best practices to maximize chances for addressing patients’ SDOH."
Social Determinants of Health and Human Papillomavirus Vaccination Among Young Adults, National Health Interview Survey 2016
"These findings can inform future HPV vaccine uptake efforts by focusing specifically on these SDOH areas—education and health and healthcare. Identifying SDOH leverage points is critical to promoting HPV vaccination and ultimately reducing HPV-associated cancers."
Nurses on the move: Robert Wood Johnson Foundation nurse faculty scholars and their action on the social determinants of health
"The RWJF Nurse Faculty Scholars were able to leverage their awards to address SDH; however, further research is needed to assess the impact of the SDH work conducted. Knowledge from this study can be used as a road map for SDH elements and areas of professional work that nurses and other health professionals could address SDH in research, teaching, service, and practice."