Social Determinants of Health

There is growing focus on using non-clinical data for health care decision making. For example, the Institute of Medicine released a report that provides recommendations for specific social determinants of health that should be captured within electronic health record systems and has also been integrated into the Quality Payment Program (Adler & Stead, 2015). Social determinants of health include factors such as socioeconomic and behavioral factors, including factors such as income, social engagement and substance abuse. Continuing into the future there will be a continued focus on using social determinants for addressing health care quality, efficiency and cost.

The purpose of this analysis is to compare health status and health conditions with social determinants of health by examining the rates of depression given population estimates, poverty rates, overall health status and reported drug use at the county level.

This scenario includes benchmarks for each appropriate variable. State-level benchmarks are accessible by filtering by state. Scenarios with multiple outcome variables require filtering by the specific outcome to return the corresponding benchmarks.

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Tutorial: Using the Data

Data Sources

Community Health Status Indicators (data released 2009)

Defining the Columns

A blank entry indicates unreported data. A value of zero is a defined value and does not represent unreported data.

State: The abbreviated name of the state where the county is located.

County: The name of the county where the information was collected. County names are listed as provided on the US Census Bureau's list of 2010 FIPS Codes for Counties and County Equivalent Entities.

Population Size: The total number of individuals residing in the county. This data is a mid-year estimate of resident population for 2008.

Children in Poverty Rate: The percentage of children under age 18 living in poverty. Poverty status is defined by family; either everyone in the family is in poverty or no one in the family is in poverty. Data is from the Small Area Income Poverty Estimates (SAIPE) in 2015.

Frequent Mental Distress Rate: The percentage of adults who reported ≥14 days in response to the question, "Now, thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?" Data is from the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2015.

Excessive Drinking Rate: The percentage of adults that report either binge drinking, defined as consuming more than 4 (women) or 5 (men) alcoholic beverages on a single occasion in the past 30 days, or heavy drinking, defined as drinking more than one (women) or 2 (men) drinks per day on average. Data is from the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2015.

Rate of Poor or Fair Health: The percentage of adults aged 18 years and older who report "fair" or "poor" overall health. The measure is provided by the Behavioral Risk Factor Surveillance System (BRFSS) survey. Data is only provided for counties with more than 50 respondents to the BRFSS survey and is from 2015.

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Tutorial: Using Excel Output