Wang Andrew, Kho Abel N, Black Bernard, French Dustin D
Institute for Public Health and Medicine, Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Institute for Public Health and Medicine, Center for Health Information Partnerships, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Inform Health Soc Care. 2021 Jun 2;46(2):205-217. doi: 10.1080/17538157.2021.1880413. Epub 2021 Feb 25.
Examining the feasibility of developing an index measure for the social determinants of health using public data is needed. We examined these characteristics at the ZIP code in California and New York using public data extracted from the US Census, American Community Survey, the USDA Food Research Access Atlas, and the Dartmouth Atlas. We conducted a retrospective study from 2000 to 2017. The main outcome was a novel index measure representing six domains (economic stability, neighborhood and physical environment, education, community and social context, food access, and health care) and encompassing 13 items. The index measure at the ZIP code was created using principal component analysis, normalized to "0" worse and "1" better in California (ZIP codes n = 1,447 to 1,515) and New York (ZIP codes n = 1,211 to 1,298). We assessed the reliability and conducted a nonparametric comparison to the Robert Wood Johnson Foundation County Health Rankings, Area Deprivation Index, Social Deprivation Index, and GINI Index. These measures shared similarities and differences with the novel measure. Mapping of this novel measure showed regional variation. As a result, developing a universal social determinants of health measure is feasible and more research is needed to link it to health outcomes.
有必要研究利用公共数据制定健康社会决定因素指数衡量标准的可行性。我们使用从美国人口普查、美国社区调查、美国农业部食品研究获取地图集和达特茅斯地图集提取的公共数据，在加利福尼亚州和纽约州的邮政编码区域对这些特征进行了研究。我们开展了一项2000年至2017年的回顾性研究。主要结果是一个代表六个领域（经济稳定性、邻里和物理环境、教育、社区和社会环境、食品获取和医疗保健）并包含13个项目的新型指数衡量标准。邮政编码区域的指数衡量标准是使用主成分分析创建的，在加利福尼亚州（邮政编码数量n = 1447至1515）和纽约州（邮政编码数量n = 1211至1298）进行了归一化处理，“0”表示更差，“1”表示更好。我们评估了其可靠性，并与罗伯特·伍德·约翰逊基金会县健康排名、地区贫困指数、社会剥夺指数和基尼指数进行了非参数比较。这些衡量标准与新衡量标准既有相似之处，也有不同之处。这种新衡量标准的映射显示出区域差异。因此，制定一个通用的健康社会决定因素衡量标准是可行的，并且需要更多研究将其与健康结果联系起来。
