scholarly journals Harnessing multiple data sources to good program planning for Rural US Veterans

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Teresa Hudson ◽  
Alyson Littman ◽  
Mary Bollinger ◽  
Edwin Wong ◽  
Karen Drummond ◽  
...  
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Geographical Variation ◽  
Program Planning ◽  
The United States ◽  
Determinants Of Health ◽  
Data Sources ◽  
Wide Range ◽  
Cold Spots ◽  
Us Veterans

ABSTRACT ObjectivesIdentify geographic variations in health and healthcare among US Veterans living in rural areas and understand the relationships between social determinants of health and these variations. ApproachData from 11 data sources will be leveraged to create the US Veterans Rural Health Atlas and chart book (VeRHA) patterned after the Dartmouth Atlas, The VeHRA will provide an interactive map and chart book can be used to efficiently examine a wide range of factors related to health and healthcare of rural Veterans. The analyses will assess the relationships between socioeconomic, cultural and environmental factors and geographical variation in access, utilization, quality, satisfaction and outcomes. Semi-structured qualitative interviews will be used to elicit the perspective of Veterans not using VA care and to identify non-governmental organizations who provide care and support to US Veterans. The project will also identify community, state, and federal entities with which ORH could form strategic partnerships to improve health and healthcare for Rural Veterans. Initially, three maps will be created for Veterans who are not enrolled in care, those enrolled but not using care and those enrolled and using care. Areas where many Veterans live and use VA healthcare will be identified as “hot spots” while areas where Veterans live but do not use care will be identified as “cold spots”. Metrics for determining “hot and cold spots” will include measures of temporal and geographic access as well as measures of quality of care. We will first calculate raw rates for outcomes across geographic areas (census tract, county, and market/regions) Exploratory Spatial Data Analysis (ESDA) will be conducted by mapping the geographic distribution of key measures and then calculate the values of the local and global Moran’s I measures of spatial autocorrelation. The relationship between social determinants of health and geographical variation in access, needs, utilization, quality, satisfaction, and outcomes for rural Veterans will be assessed, focused primarily on the “cold spots” – areas of greatest need. ResultsThe project is a work in progress with initial maps created showing the density of Veterans across the United States. More extensive results will be available for presentation. ConclusionThis work demonstrates the value of using large data sets to guide development of policies and programs at a national level.

scholarly journals Concepts and Terms for Addressing Disparities in Public Health Emergencies: Accounting for the COVID-19 Pandemic and the Social Determinants of Health in the United States

2021 ◽  
pp. 1-25
Author(s):  
Cheryl A. Levine ◽  
Daire R. Jansson
Keyword(s):  
Public Health ◽  
United States ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
The United States ◽  
Determinants Of Health ◽  
Public Health Emergencies ◽  
Wide Range ◽  
Conceptual Shift ◽  
Systemic Health

Abstract Public health emergencies, including the coronavirus (COVID-19) pandemic, highlight disproportionate impacts faced by populations with existing disparities. Concepts and terms used to describe populations disproportionately impacted in emergencies vary over time and across disciplines, but United States (U.S.) federal guidance and law require equal access to our nation’s emergency resources. At all levels of emergency planning, public health and their partners must be accountable to populations with existing inequities, which requires a conceptual shift towards using the data-driven social determinants of health (SDOH). SDOH are conditions in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks. This article reviews the historic use of concepts and terms to describe populations disproportionately impacted by emergencies. It also recommends a shift in emergency activities towards interventions that target the SDOH to adequately address long-standing systemic health disparities and socioeconomic inequities in the U.S.

scholarly journals Toward Understanding the Value of Missing Social Determinants of Health Data in Care Transition Planning

2020 ◽  
Vol 11 (04) ◽  
pp. 556-563
Author(s):  
Sue S. Feldman ◽  
Ganisher Davlyatov ◽  
Allyson G. Hall
Keyword(s):  
Social Determinants Of Health ◽  
Social Determinants ◽  
Transition Planning ◽  
Program Planning ◽  
Relative Weight ◽  
Determinants Of Health ◽  
Care Transition ◽  
Data Set ◽  
Independent Variables ◽  
Weight Analysis

Abstract Background Social determinants of health play an important role in the likelihood of readmission and therefore should be considered in care transition planning. Unfortunately, some social determinants that can be of value to care transition planners are missing in the electronic health record. Rather than trying to understand the value of data that are missing, decision makers often exclude these data. This exclusion can lead to failure to design appropriate care transition programs, leading to readmissions. Objectives This article examines the value of missing social determinants data to emergency department (ED) revisits, and subsequent readmissions. Methods A deidentified data set of 123,697 people (18+ years), with at least one ED visit in 2017 at the University of Alabama at Birmingham Medical Center was used. The dependent variable was all-cause 30-day revisits (yes/no), while the independent variables were missing/nonmissing status of the social determinants of health measures. Logistic regression was used to test the relationship between likelihood of revisits and social determinants of health variables. Moreover, relative weight analysis was used to identify relative importance of the independent variables. Results Twelve social determinants were found to be most often missing. Of those 12, only “lives with” (alone or with family/friends) had higher odds of ED revisits. However, relative logistic weight analysis suggested that “pain score” and “activities of daily living” (ADL) accounted for almost 50% of the relevance for ED revisits when compared among all 12 variables. Conclusion In the process of care transition planning, data that are documented are factored into the care transition plan. One of the most common challenges in health services practice is to understand the value of missing data in effective program planning. This study suggests that the data that are not documented (i.e., missing) could play an important role in care transition planning as a mechanism to reduce ED revisits and eventual readmission rates.

scholarly journals Social Determinants of Health among Older Korean Immigrants in the United States: A Systematic Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 961-961
Author(s):  
Sojeong Lee ◽  
Victoria Rizzo
Keyword(s):  
United States ◽  
Systematic Review ◽  
Health Disparities ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
The United States ◽  
Korean Immigrants ◽  
Determinants Of Health ◽  
Inclusion Criteria ◽  
Older Korean Immigrants

Abstract The visible impact of the SDoHs on health and behavioral health as well as health disparities among minority populations is heightened due to COVID-19. One group about which little is known in relation to SDoHs is the older Korean immigrant population in the U.S. To examine the impact of SDoHs on the health, mental health, and health care utilization, a systematic review of studies focused on SDoHs for this population was conducted. Using multiple indexing terms, databases were searched for articles published in English between January 1, 2011 and December 2020. Articles were included in the search if they examined social determinants of health of older Korean immigrants defined as foreign-born Koreans aged 60 or older who live in the United States regardless of citizenship or legal immigration status. A total of 1090 articles were identified in the search. A review of abstracts for inclusion criteria resulted in 118 articles for review. Seventy-one articles were excluded during the review process. A total of 47 articles met inclusion criteria and were evaluated. The review revealed that SDoHs, including education level, financial resources, access to health insurance, level of acculturation and level of social support, influenced cognitive status, depressive symptoms, health status and quality of life. These findings validate the need for interventions to address the social care needs of older Korean immigrants and can be used to identify the role of social workers in addressing the SDoHs that result in health disparities for older Korean immigrants.

scholarly journals Creation and Validation of a Polysocial Score for Mortality Among Community-Dwelling Older Adults in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 164-164
Author(s):  
Yongjing Ping ◽  
Chenkai Wu ◽  
Michelle Odden ◽  
Robert Stawski ◽  
Hoda Magid
Keyword(s):  
Older Adults ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
The United States ◽  
Community Dwelling ◽  
Determinants Of Health ◽  
Stepwise Logistic Regression ◽  
Social Environments ◽  
Social Interventions

Abstract The interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. Since the older population had highly diverse social backgrounds, a new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Participants ([n = 7383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the Health and Retirement Study (HRS) at study entry in 2006 or 2008. Social determinants of health encompassing five social domains: economic stability, neighborhood and physical environment, education, community and social context, and health care system. Five-year mortality was calculated as the number of years from the interview date to the death date. We used the forward stepwise logistic regression to construct the polysocial score and multivariate logistic regressions to assess the associations between polysocial score and five-year mortality. Polysocial score (range: 7 to 59, mean±SD: 35.5±7.5) was created using 15 social determinants of health. Of the 7383 participants, 491 (30.8%), 599 (17.2%), and 166 (7.8%) deaths occurred over five years among participants with a low (0-29), intermediate (30-39), and high (40+) polysocial score, respectively. Participants with an intermediate (Odds Ratio [OR]=0.76; 95% CI, 0.65-0.89) or high (OR=0.46; 95% CI, 0.36-0.59) polysocial score had higher odds of death than those in the low category in the fully adjusted model, respectively. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older adults to improve their social status for specific health outcomes.

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