Determining the feasibility of an index of the social determinants of health using data from public sources

ABSTRACT

Examining the feasibility of developing an index measure for the social determinants of health using public data is needed. We examined these characteristics at the ZIP code in California and New York using public data extracted from the US Census, American Community Survey, the USDA Food Research Access Atlas, and the Dartmouth Atlas. We conducted a retrospective study from 2000 to 2017. The main outcome was a novel index measure representing six domains (economic stability, neighborhood and physical environment, education, community and social context, food access, and health care) and encompassing 13 items. The index measure at the ZIP code was created using principal component analysis, normalized to “0” worse and “1” better in California (ZIP codes n = 1,447 to 1,515) and New York (ZIP codes n = 1,211 to 1,298). We assessed the reliability and conducted a nonparametric comparison to the Robert Wood Johnson Foundation County Health Rankings, Area Deprivation Index, Social Deprivation Index, and GINI Index. These measures shared similarities and differences with the novel measure. Mapping of this novel measure showed regional variation. As a result, developing a universal social determinants of health measure is feasible and more research is needed to link it to health outcomes.

KEYWORDS:

• Social determinants of health
• social risk factors
• index measure
• socioeconomic status
• risk adjustment
• Disparities
• Equity

Acknowledgments

We are grateful for the support provided by Jane Holl, MD, MPH in the conceptualization of this project.

Disclosure statement:

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government (French)

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Agency for Healthcare Research and Quality’s (AHRQ) National Research Service Award Institutional Research T32 Training Grant HS000078/HS000084.