The association of social determinants of health with health outcomes

Linda D Highfield

27 citations0/0 files storedThe American Journal of Managed Care

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Health disparities and outcomes Healthcare Policy and Management Public Health and Social Inequalities

Abstract

OBJECTIVES: This study explored the contributions of social determinants of health (SDOH) to measures of population health-specifically cost, hospitalization rates, rate of emergency department utilization, and health status-in Texas. STUDY DESIGN: The study associated common SDOH metrics from public data sources (county specific) with health plan enrollment data (including demographics, counties, and zip codes) and medical and pharmaceutical annual claims data. METHODS: Following correlation analyses to reduce variables, the contribution of each SDOH individually and by category to the health outcomes was evaluated. Separate matrices for age populations (under age 19, general population [all ages], and ≥ 65 years) were created with assigned weights of influence for categories and the factors within each category. RESULTS: The contributions of the categories varied by population, confirming that different SDOH influence populations to varying degrees. This was reflected in each model. The largest contributor to cost for the general population and for the group 65 years and older was factors grouped as health outcomes (such as perceived health), at 43.5% contribution and 37.7% contribution, respectively. Yet for the population younger than 19 years, the largest contributor to cost was socioeconomic factors (such as unemployment rate), at 40.2%. The other performance measures also varied by population and the mix and weight of determinants. CONCLUSIONS: This study and the developed population-based matrices can provide a valuable framework for reporting the impact of SDOH on health care quality. The variation suggests the need for further research on how age groups react to the social environment.

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2015County Health Rankings 2018Measuring Community Vulnerability to Natural and Anthropogenic Hazards: The Centers for Disease Control and Prevention's Social Vulnerability Index.2015Public Health Monitoring of Privilege and Deprivation With the Index of Concentration at the Extremes 2016Introduction of an Area Deprivation Index Measuring Patient Socio-economic Status in an Integrated Health System: Implications for Population Health 2015Relative Contributions of a Set of Health Factors to Selected Health Outcomes

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