Top Things to Know: 2024 ACC/AHA Key Data Elements and Definitions for Social Determinants of Health in Cardiology
Published: August 26, 2024
- Social factors have been increasingly recognized as important, and in some cases dominant, determinants of health outcomes. Clarity around the definitions of these social determinants of health (SDOH) is an important component to advancing clinical care and research focused on reducing health disparities and optimizing outcomes for all individuals throughout the lifespan.
- To inform their work, the writing group assessed several conceptual frameworks to characterize the relationship between social factors and health.
- This document provides standard definitions for SDOH relevant to cardiovascular disease (CVD). After an environmental scan of extensive existing data standards, the writing group generated consensus about the data elements and definitions most relevant to cardiovascular care.
- SDOH can be characterized at the individual level, the interpersonal level, or the community or societal level. These contribute to a comprehensive understanding of social influences on health outcomes.
- Individual-level SDOH consists of the domains: 1) race, ethnicity, sex, sexual orientation, gender identity, immigration status, and acculturation; 2) language and literacy; 3) educational attainment, income, and employment; 4) health literacy, broadband access, and digital literacy; 5) dietary quality, and food access and security; and 6) health insurance.
- Interpersonal SDOH includes the domains of: 1) social connection and network; 2) interpersonal discrimination; 3) disparate health care quality; and 4) psychosocial stress.
- Community-level SDOH consists of the domains: 1) racial segregation; 2) housing quality; 3) civic participation and voting rights; 4) access to and availability of health care services; 5) community-level education and employment; 6) community-level rates of incarceration and violence; 7) transportation access and walkability; 8) research infrastructure and access to clinical trials; and 9) area-level composite indices.
- SDOH at the individual, interpersonal, and community level may overlap and are not mutually exclusive.
- Implementing these data standards will require that data attributes such as data formats, data types, target values, and mapping to standardized code sets be developed.
- Strategies to integrate SDOH in electronic health records (EHRs) and data repositories will be necessary to ensure that these data standards can be deployed to achieve more equitable health and optimal health outcomes.
Citation
Morris AA, Masoudi FA, Abdullah AR, Banerjee A, Brewer LC, Commodore-Mensah Y, Cram P, DeSilvey SC, Hines AL, Ibrahim NE, Jackson EA, Joynt Maddox KE, Makaryus AN, Piña IL, Rodriguez-Monserrate CP, Roger VL, Thorpe F, Williams KA Sr. 2024 ACC/AHA key data elements and definitions for social determinants of health in cardiology:a report of the American College of Cardiology/American Heart Association Joint Committee on clinical datastandards. Circulation: Cardiovascular Quality and Outcomes. Published online August 26, 2024. doi: 10.1161/HCQ.0000000000000133