Using area-level measures of social determinants of health to deliver improved and effective health care
Pallavi Jonnalagadda, Christine M. Swoboda, Naleef Fareed
Abstract
Abstract: There is growing emphasis on social determinants of health (SDoH) and their role in health care outcomes and health care delivery. Despite the importance of SDoH in determining individual health, this information is not routinely or systematically captured during clinical encounters. Providers cite lack of time, hesitation to ask patients for personal information, and lack of confidence in addressing social risk factors as barriers to the routine collection and use of SDoH in clinical practice. SDoH have been operationalized as composite scores of measures spanning several domains such as transport, income, crime, housing, and built environment at the area level. Living in deprived neighborhoods has been associated with adverse health outcomes. Several national and international efforts have focused on using area-level measures of SDoH to describe area-level deprivation information, or its counterpart, opportunity that measures potential for human progress, to communicate implications for individual and population health outcomes. We provide an overview of the current state of the field to orient readers to area-level measures of SDoH. We briefly discuss potential applications and limitations of area-level SDoH, as well as, implications for health care and health policy. Our overview is likely to help with the design and evaluation of health care interventions that aim to use area-level measures of SDoH.