Using a Social Determinants of Health Summary Measure to Predict General Health Status in the BRFSS

2021 ◽  
pp. 089011712110449
Author(s):  
Candace C. Nelson

Purpose This study aims to assess the relationship between social determinants of health (SDoH) burden and overall health. Design Three years of Behavioral Risk Factor Surveillance System (BRFSS) data (2017–2019) were combined for this cross-sectional study. Setting Massachusetts. Subjects Out of a possible 21,312 respondents, 16,929 (79%) were eligible for inclusion. Measures To create the SDoH summary measure, items assessing social risk experiences including financial instability (1 item), housing instability (2 items), perceptions of neighborhood crime (1 item), and food insecurity (2 items) were summed to create a count of risk experiences. Outcome measures included self-rated general health, days of poor physical health, and days of poor mental health. Analysis Multivariable logistic regression was used to evaluate the association between each outcome and the SDoH summary measure, adjusting for demographic confounders. Results In adjusted analyses, respondents who reported experiencing 1, 2, 3, or 4+ SDoH had a 1.6 (95% CI: 1.3–2.0), 2.9 (95% CI: 2.3–3.7), 3.2 (95% CI: 2.4–4.3), or 5.3 (95% CI: 4.0–7.0) increased odds (respectively) of self-rated fair/poor health, compared to those who reported zero SDoH. The adjusted relationship between the SDoH summary measure and physical health and mental health was similar in magnitude and statistically significant. Conclusions These results demonstrate that the overall burden of risk due to SDoH is an important predictor of health.

2018 ◽  
Vol 41 (3) ◽  
pp. e218-e225
Author(s):  
Dennis Raphael

Abstract Background This article overviews Canadian work on the social determinants of oral and general health noting their affinities and differences. Methods A literature search identified Canadian journal articles addressing the social determinants of oral health and/or oral health inequalities. Analysis identified affinities and differences with six themes in the general social determinants of health literature. Results While most Canadian social determinants activity focuses on physical and mental health there is a growing literature on oral health—literature reviews, empirical studies and policy analyses—with many affinities to the broader literature. In addition, since Canada provides physical and mental health services on a universal basis, but does not do so for dental care, there is a special concern with the reasons behind, and the health effects—oral, physical and mental—of the absence of publicly financed dental care. Conclusions The affinities between the social determinants of oral health and the broader social determinants of health literature suggests the value of establishing a common research and action agenda. This would involve collaborative research into common social determinants of oral and general health and combined policy advocacy efforts to improve Canadians’ living and working conditions as means of achieving health for all.


2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S151-S152
Author(s):  
Luis H Quiroga ◽  
Tomer Lagziel ◽  
Mohammed Asif ◽  
Raymond Fang ◽  
Grace F Rozycki ◽  
...  

Abstract Introduction To our knowledge, no studies have been conducted assessing the social determinants of health and the impact on the outcomes for burn patients. Such studies are needed considering burn injuries are associated with high costs, severe psychological impact, and a high burden placed on the healthcare systems. The burden is hypothesized to be aggravated by the increasing amount of diabetes and obesity seen in the general population which put patients at increased risk for developing chronic wounds. Studies have shown that several socioeconomic status (SES) factors are associated with increased risk of burns, but none have documented the outcomes of burn patients based on their social determinants of health. In our study, we will be comparing patients in the burn ICU (BICU) to patients in the surgical ICU (SICU). The purpose of this comparison is to evaluate whether the same social determinants of health have similar influences in both groups. Methods We performed a retrospective analysis of population group data from patients admitted to the BICU and SICU from January 1, 2016, to November 18, 2019. The primary outcomes were length-of-stay (LOS), mortality, 30-day-readmission, and hospital charges. Pearson’s chi-square test for categorical variables and t-test for continuous variables were used to compare population health groups. Results We analyzed a total of 487 burn and 510 surgical patients. When comparing BICU and SICU patients, we observed significantly higher mean hospital charges and LOS in burn patients with a history of mental health (mean difference: $42,756.04, p=0.013 and 7.12 days, p=0.0085), ESRD ($57,8124.7, p=0.0047 and 78.62 days, p=0.0104), sepsis ($168,825.19, p=< 0.001 and 20.68 days, p=0.0043), and VTE ($63,9924.1, p=< 0.001 and 72.9 days, p=0.002). Also, higher mortality was observed in burn patients with ESRD, STEMI, sepsis, VTE, and diabetes mellitus. Burn patients with a history of mental health, drug dependence, heart failure, and diabetes mellitus also had greater 30-day-readmissions rates. Conclusions This study sheds new knowledge on the considerable variability that exists between the different population health groups in terms of outcomes for each cohort of critically ill patients. It demonstrates the impacts of population health group on outcomes. These population groups and social determinants have different effects on BICU versus SICU patients and this study provides supporting evidence for the need to identify and develop new strategies to decrease overspending in healthcare. Further research to develop relevant and timely interventions that can improve these outcomes.


2019 ◽  
Vol 26 (8-9) ◽  
pp. 895-899 ◽  
Author(s):  
Joseph J Deferio ◽  
Scott Breitinger ◽  
Dhruv Khullar ◽  
Amit Sheth ◽  
Jyotishman Pathak

Abstract Social determinants of health (SDOH) are known to influence mental health outcomes, which are independent risk factors for poor health status and physical illness. Currently, however, existing SDOH data collection methods are ad hoc and inadequate, and SDOH data are not systematically included in clinical research or used to inform patient care. Social contextual data are rarely captured prospectively in a structured and comprehensive manner, leaving large knowledge gaps. Extraction methods are now being developed to facilitate the collection, standardization, and integration of SDOH data into electronic health records. If successful, these efforts may have implications for health equity, such as reducing disparities in access and outcomes. Broader use of surveys, natural language processing, and machine learning methods to harness SDOH may help researchers and clinical teams reduce barriers to mental health care.


2013 ◽  
Vol 32 (1) ◽  
pp. 43-57 ◽  
Author(s):  
Shawn R. Currie ◽  
Kirsten Fiest ◽  
Lindsay Guyn

The effect of social determinants of health on depression prevalence and treatment access was examined using community survey and administrative data on mental health service users in the Calgary Health Region (CHR). Consistent with national prevalence data, depression was significantly associated with female gender, younger age, and health risk factors such as smoking, hypertension, and obesity. The prevalence of depression causing interference in daily functioning across 19 social districts (subregions within the CHR) was significantly related to community-level indicators of single-parent status, low-income families, and low educational achievement in each district. Disparities in treatment access were also found with persons living in the most impoverished districts having the lowest rates of accessing professional mental health services.


2022 ◽  
Vol 21 (1) ◽  
pp. 179-202
Author(s):  
Mariel Heredia ◽  
Esther Carlota Gallegos Cabriales

Objective: Describe the relationship between social determinants of health and risk of type 2 diabetes mellitus in Mexican population.Methods: This was a cross-sectional descriptive correlational study of a sample of 256 individuals from a rural community in Sinaloa, Mexico. Data collection was carried out from October 2020 to February 2021. A snowball non-probability sampling method was used. The Instruments used were the International Physical Activity Questionnaire (IPAQ), short version, the IPAQ-A for adults, the IPAQ-C for children, and a sociodemographic, anthropometric, and clinical data sheet.Results: The most frequent risk indicators for T2DM for adults are hypertension (81.7%) and overweight/obesity (68.6%); in children, it was overweight/obesity (34.9%). The risk of T2DM increased according to age (r = .560, p < .01) but decreased as education level increased (r = −.127, p < .05)Conclusions: The approach to T2DM risk factors from the perspective of social determinants of health allows strategic healthcare planning that considers the contextual factors associated with a lifestyle that reinforces the actions of healthcare providers. Objetivo: Describir la relación de los determinantes sociales de salud con el riesgo de DMT2 en población mexicana.Métodos: Estudio descriptivo correlacional transversal, con una muestra de 256 individuos de una comunidad rural de Sinaloa, México. La recolección de datos se realizó durante octubre de 2020 y febrero de 2021. El muestreo fue no probabilístico por bola de nieve. Los instrumentos utilizados fueron el cuestionario internacional de actividad física (IPAQ) versión corta, IPAQ-A, IPAQ-C y una hoja de registro datos sociodemográficos, antropométricos y clínicos.Resultados: Los indicadores de riesgo de DMT2 con mayor frecuencia para adultos fue padecer hipertensión arterial (81.7%) y SP/OB (68.6%) y para menores de edad fue tener SP/OB (34.9%). Resultó que el riesgo de DMT2 se acrecentaba según lo hacía la edad (r = .560, p < .01) pero disminuía al aumentar la escolaridad de las personas (r = -.127, p < .05).Conclusiones: El abordaje de factores de riesgo de DMT2 bajo la perspectiva de los DSS brinda la oportunidad de plantear estrategias de salud que contemplen factores contextuales simultáneos al estilo de vida que refuercen las acciones del personal de salud para contribuir a la reducción de los índices de morbimortalidad causados por la DMT2.


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Sheila V. Kusnoor ◽  
Taneya Y. Koonce ◽  
Suzanne T. Hurley ◽  
Kalonji M. McClellan ◽  
Mallory N. Blasingame ◽  
...  

Author(s):  
Jessica Wallace ◽  
Erica Beidler ◽  
Johna K. Register-Mihalik ◽  
Tamaria Hibbler ◽  
Abigail Bretzin ◽  
...  

Abstract Context: There is limited research concerning the relationship between social determinants of health, including race, healthcare access, socioeconomic status (SES), and physical environment; and, concussion nondisclosure in college-athletes. However, in high school athletes, disparities have been noted, with Black athletes attending under-resourced schools and lacking access to an athletic trainer (AT) disclosing fewer concussions. Objective: To investigate whether concussion nondisclosure disparities exist by 1) race, 2) SES, and 3) AT healthcare access prior to college; and to understand the differential reasons for concussion nondisclosure between Black and White college-athletes. Design: Cross-sectional Setting: College athletics Participants: 735 college-athletes (84.6% White, 15.4% Black) Main Outcome Measures: Participants completed a questionnaire that directly assessed concussion nondisclosure, including reasons for not reporting a suspected concussion. With the premise of investigating social determinants of health, race was the primary exposure of interest. The outcome of interest, nondisclosure, was assessed with a binary (yes/no) question, “Have you ever sustained a concussion that you did not report to your coach, athletic trainer, parent, teammate, or anyone else?” Results: Overall, among White and Black athletes 15.6% and 17.7% respectively reported a history of concussion nondisclosure. No significant differences were found by race for distributions of history of concussion nondisclosure (p=0.57). Race was not associated with concussion nondisclosure when evaluated as an effect modification measure or confounder; and, no significant associations were noted by SES or high school AT access. Differences by race for reported reasons for nondisclosure were found for: “At the time I did not think it was a concussion” (p=0.045) and “I thought my teammates would think I am weak” (p=0.03) with Black athletes reporting these more frequently than White athletes. Conclusions: These data help to contextualize race and its intersection with other social determinants of health that could influence concussion nondisclosure outcomes in college-athletes.


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