Comparison of Empirically Identified Social Determinant of Health (SDH) Domains from Health Center Screening Documents Compared with Other Recommended SDH Data Collection Domains
| Empirically Identified Domains from Health Centers* | NAM† | HP2020‡ | National Quality Forum§ | USPSTF‖ | WHO¶ | UDS# | #Meaningful Use Stages 2/3** |
|---|---|---|---|---|---|---|---|
| Culture (religious/spiritual affiliations or practices) | |||||||
| Demographics (gender/sex, place of birth, sexual orientation, race/ethnicity) | x | x | x | x | x | x | |
| Economic indicators (income, assets, assistance programs, indebtedness) | x | x | x | x | x | ||
| Education (educational attainment, basic literacy, health literacy, numeracy) | x | x | x | x | x | ||
| Employment status (unemployment, OSHA, migrant/seasonal or farm worker, day laborers, disability status, mobility status, retirement status, student, unpaid caretaker, active military) | x | x | x | x | x | ||
| Family/living arrangements (marital status, dependents, children, elders, who lives in the home) | x | ||||||
| Functional status (ADLs/IADLs, frailty) | x | ||||||
| Health-related behaviors (alcohol use, caffeine use, drug use, tobacco use, secondhand smoke, physical activity, sexual activity, diet, safety, bike helmets, baby-proof, seat belts, smoke detectors, guns in the home, driving safety, screen time) | x | x | x | x | |||
| Health care access (insurance status, affordability, usual source of care) | x | x | x | ||||
| Language (primary language, English proficiency, interpreter, other language proficiency) | x | x | x | x | |||
| Material hardship (food insecurity, housing insecurity, utilities, transportation, medication affordability, access to technology, child care, legal services) | x | x | x | x | x | x | |
| Mental health (depression, anxiety, PTSD, ADD/ADHD, suicide risk, stress, caregiver stress, burnout, sleep behaviors) | x | x | x | x | |||
| Social support (community activities, safe environment, environmental exposures, personal safety, bullying, public spaces, racism, discrimination, distrust, school culture) | x | x | x | x | x | ||
| Trauma/violence (intimate partner violence, trauma, physical abuse, sexual abuse, mental abuse, child abuse) | x | x | |||||
| Veteran status (history of military trauma, combat veteran) | x |
↵* Bold items represent the core domains; subdomains are set in parentheses.
↵† National Academy of Medicine (NAM) Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2.7
↵‡ Healthy People 2020.9
↵§ National Quality Forum, Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors.21
↵‖ U.S. Preventive Services Task Force (USPSTF) published recommendations.29
↵¶ World Health Organization (WHO), A Conceptual Framework for Action on the Social Determinants of Health.22
↵# Uniform Data System (UDS) reporting measures.19
↵** Secretary of Health and Human Services, Health Information Technology Certification Criteria, 2015 edition.30
ADD, attention deficit disorder; ADHD, attention deficit and hyperactivity disorder; ADL, activity of daily living; HP2020, Healthy People 2020; IADLs, instrumental activity of daily living; OSHA, Occupation Safety and Health Administration; PTSD, posttraumatic stress disorder.