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Exploring consensus across sectors for measuring the social determinants of health.

ABSTRACT: The importance of social determinants of health (SDOH) -such as affordable housing, stable employment, consistent transportation, healthy food access, and quality schools-is well-established as a key component of chronic disease prevention and health promotion. Increasingly, practitioners within and beyond public health are collaborating to implement such strategies, part of which involves measuring their impacts over time. This study assesses the current state of SDOH measurement across sectors by systematically identifying how many and what kinds of tools exist and whether there is consensus around SDOH categories and indicators selected. 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.

SUBMITTER: Elias RR

PROVIDER: S-EPMC6484213 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Exploring consensus across sectors for measuring the social determinants of health.

Elias Renee Roy RR Jutte Douglas P DP Moore Alison A

SSM - population health 20190409

The importance of social determinants of health (SDOH) -such as affordable housing, stable employment, consistent transportation, healthy food access, and quality schools-is well-established as a key component of chronic disease prevention and health promotion. Increasingly, practitioners within and beyond public health are collaborating to implement such strategies, part of which involves measuring their impacts over time. This study assesses the current state of SDOH measurement across sectors ...[more]

PMID: 31049390

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Project description:BackgroundVeterans Health Administration (VHA) is committed to providing high-quality care and addressing health disparities for vulnerable Veterans. To meet these goals, VA policymakers need guidance on how to address social determinants in operations planning and day-to-day clinical care for Veterans.MethodMEDLINE (OVID), CINAHL, PsycINFO, and Sociological Abstracts were searched from inception to January 2017. Additional articles were suggested by peer reviewers and/or found through search of work associated with US and VA cohorts. Eligible articles compared Veterans vs non-Veterans, and/or Veterans engaged with those not engaged in VA healthcare. Our evidence maps summarized study characteristics, social determinant(s) addressed, and whether health behaviors, health services utilization, and/or health outcomes were examined. Qualitative syntheses and quality assessment were performed for articles on rurality, trauma exposure, and sexual orientation.ResultsWe screened 7242 citations and found 131 eligible articles-99 compared Veterans vs non-Veterans, and 40 included engaged vs non-engaged Veterans. Most articles were cross-sectional and addressed socioeconomic factors (e.g., education and income). Fewer articles addressed rurality (N?=?20), trauma exposure (N?=?17), or sexual orientation (N?=?2); none examined gender identity. We found no differences in rural residence between Veterans and non-Veterans, nor between engaged and non-engaged Veterans (moderate strength evidence). There was insufficient evidence for role of rurality in health behaviors, health services utilization, or health outcomes. Trauma exposures, including from events preceding military service, were more prevalent for Veterans vs non-Veterans and for engaged vs non-engaged Veterans (low-strength evidence); exposures were associated with smoking (low-strength evidence).DiscussionLittle published literature exists on some emerging social determinants. We found no differences in rural residence between our groups of interest, but trauma exposure was higher in Veterans (vs non-Veterans) and engaged (vs non-engaged). We recommend consistent measures for social determinants, clear conceptual frameworks, and analytic strategies that account for the complex relationships between social determinants and health.

Dataset Information

Exploring consensus across sectors for measuring the social determinants of health.

Publications

Exploring consensus across sectors for measuring the social determinants of health.

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