Standardizing social determinants of health data: a proposal for a comprehensive screening tool to address health equity a systematic review.

Health affairs scholar Pub Date : 2024-11-14 eCollection Date: 2024-12-01 DOI:10.1093/haschl/qxae151
Sarju Ganatra, Sumanth Khadke, Ashish Kumar, Sadiya Khan, Zulqarnain Javed, Khurram Nasir, Sanjay Rajagopalan, Rishi K Wadhera, Sourbha S Dani, Sadeer Al-Kindi
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Abstract

Social determinants of health (SDoH) significantly impacts health outcomes and disparities. While the Centers for Medicare and Medicaid Services has mandated hospitals to collect standardized SDoH data, existing tools lack key elements. This systematic review identified 78 studies and 20 screening tools addressing various SDoH domains. However, most tools were missing several key domains and lacked standardization. We propose a comprehensive tool meeting essential criteria: validated questions, brevity, actionability, cultural appropriateness, workflow integration, and community linkage. Our tool addresses gaps in available tools and incorporates standardized and validated questions to enable patient-centered screening for diverse social and environmental determinants of health. It uniquely includes detailed race/ethnicity data collection, housing characteristics, physical activity assessment, access to healthy food measures, and environmental exposure evaluation. The tool aims to provide actionable data for immediate interventions while informing broader population health strategies and policy initiatives. By offering a holistic assessment of SDoH across multiple domains, our tool enables standardized data collection, risk stratification, and focused initiatives to address health inequities at both individual and population levels. Further research is needed to develop evidence-based pathways for integrating SDoH data into real-world patient care workflows, improve risk prediction algorithms, address health-related social needs, and reduce disparities.

健康数据的社会决定因素标准化:关于采用综合筛查工具解决健康公平问题的建议,系统综述。
健康的社会决定因素(SDoH)对健康结果和差异有重大影响。尽管美国医疗保险和医疗补助服务中心(Centers for Medicare and Medicaid Services)已要求医院收集标准化的 SDoH 数据,但现有工具缺乏关键要素。本系统综述确定了 78 项研究和 20 种筛查工具,涉及 SDoH 的各个领域。然而,大多数工具都缺少几个关键领域,并且缺乏标准化。我们提出了一种符合基本标准的综合工具:经过验证的问题、简洁、可操作性、文化适宜性、工作流程整合以及社区联系。我们的工具弥补了现有工具的不足,并纳入了标准化的验证问题,能够以患者为中心筛查各种社会和环境健康决定因素。它独特地包含了详细的种族/民族数据收集、住房特征、体育活动评估、健康食品获取措施以及环境暴露评估。该工具旨在为即时干预提供可操作的数据,同时为更广泛的人口健康战略和政策倡议提供信息。通过提供跨多个领域的 SDoH 整体评估,我们的工具可以实现标准化的数据收集、风险分层和有针对性的措施,以解决个人和人群层面的健康不平等问题。我们需要开展进一步的研究,以开发基于证据的途径,将 SDoH 数据整合到现实世界的患者护理工作流程中,改进风险预测算法,满足与健康相关的社会需求,并缩小差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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