Table 2.

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*NAMHP2020National Quality Forum§USPSTFWHOUDS##Meaningful Use Stages 2/3**
Culture (religious/spiritual affiliations or practices)
Demographics (gender/sex, place of birth, sexual orientation, race/ethnicity)xxxxxx
Economic indicators (income, assets, assistance programs, indebtedness)xxxxx
Education (educational attainment, basic literacy, health literacy, numeracy)xxxxx
Employment status (unemployment, OSHA, migrant/seasonal or farm worker, day laborers, disability status, mobility status, retirement status, student, unpaid caretaker, active military)xxxxx
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)xxxx
Health care access (insurance status, affordability, usual source of care)xxx
Language (primary language, English proficiency, interpreter, other language proficiency)xxxx
Material hardship (food insecurity, housing insecurity, utilities, transportation, medication affordability, access to technology, child care, legal services)xxxxxx
Mental health (depression, anxiety, PTSD, ADD/ADHD, suicide risk, stress, caregiver stress, burnout, sleep behaviors)xxxx
Social support (community activities, safe environment, environmental exposures, personal safety, bullying, public spaces, racism, discrimination, distrust, school culture)xxxxx
Trauma/violence (intimate partner violence, trauma, physical abuse, sexual abuse, mental abuse, child abuse)xx
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.