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      Documenting social determinants of health-related clinical activities using standardized medical vocabularies.

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          Abstract

          Growing recognition that health is shaped by social and economic circumstances has resulted in a rapidly expanding set of clinical activities related to identifying, diagnosing, and intervening around patients' social risks in the context of health care delivery. The objective of this exploratory analysis was to identify existing documentation tools in common US medical coding systems reflecting these emerging clinical practices to improve patients' social health.

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          Most cited references24

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          Population-based norms for the Mini-Mental State Examination by age and educational level.

          R Crum, J C Anthony, S S Bassett … (1993)
          To report the distribution of Mini-Mental State Examination (MMSE) scores by age and educational level. National Institute of Mental Health Epidemiologic Catchment Area Program surveys conducted between 1980 and 1984. Community populations in New Haven, Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Calif. A total of 18,056 adult participants selected by probability sampling within census tracts and households. Summary scores for the MMSE are given in the form of mean, median, and percentile distributions specific for age and educational level. The MMSE scores were related to both age and educational level. There was an inverse relationship between MMSE scores and age, ranging from a median of 29 for those 18 to 24 years of age, to 25 for individuals 80 years of age and older. The median MMSE score was 29 for individuals with at least 9 years of schooling, 26 for those with 5 to 8 years of schooling, and 22 for those with 0 to 4 years of schooling. Cognitive performance as measured by the MMSE varies within the population by age and education. The cause of this variation has yet to be determined. Mini-Mental State Examination scores should be used to identify current cognitive difficulties and not to make formal diagnoses. The results presented should prove to be useful to clinicians who wish to compare an individual patient's MMSE scores with a population reference group and to researchers making plans for new studies in which cognitive status is a variable of interest.
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            Actual causes of death in the United States.

            J McGinnis, W Foege (1993)
            To identify and quantify the major external (nongenetic) factors that contribute to death in the United States. Articles published between 1977 and 1993 were identified through MEDLINE searches, reference citations, and expert consultation. Government reports and complications of vital statistics and surveillance data were also obtained. Sources selected were those that were often cited and those that indicated a quantitative assessment of the relative contributions of various factors to mortality and morbidity. Data used were those for which specific methodological assumptions were stated. A table quantifying the contributions of leading factors was constructed using actual counts, generally accepted estimates, and calculated estimates that were developed by summing various individual estimates and correcting to avoid double counting. For the factors of greatest complexity and uncertainty (diet and activity patterns and toxic agents), a conservative approach was taken by choosing the lower boundaries of the various estimates. The most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400,000 deaths), diet and activity patterns (300,000), alcohol (100,000), microbial agents (90,000), toxic agents (60,000), firearms (35,000), sexual behavior (30,000), motor vehicles (25,000), and illicit use of drugs (20,000). Socioeconomic status and access to medical care are also important contributors, but difficult to quantify independent of the other factors cited. Because the studies reviewed used different approaches to derive estimates, the stated numbers should be viewed as first approximations. Approximately half of all deaths that occurred in 1990 could be attributed to the factors identified. Although no attempt was made to further quantify the impact of these factors on morbidity and quality of life, the public health burden they impose is considerable and offers guidance for shaping health policy priorities.
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              Addressing social determinants of health at well child care visits: a cluster RCT.

              Arvin Garg, Sarah Toy, Yorghos Tripodis … (2015)
              To evaluate the effect of a clinic-based screening and referral system (Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education [WE CARE]) on families' receipt of community-based resources for unmet basic needs.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): JAMIA Open
                Title: JAMIA open
                Publisher: Oxford University Press (OUP)
                ISSN (Electronic): 2574-2531
                ISSN (Print): 2574-2531
                Publication date (Electronic): Apr 2019
                Volume: 2
                Issue: 1
                Affiliations
                [1 ] Social Interventions Research and Evaluation Network, University of California San Francisco, San Francisco, California, USA.
                [2 ] Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.
                [3 ] Department of Family and Community Medicine, University of California San Francisco, San Francisco, California, USA.
                Article
                Publisher Item ID: ooy051
                DOI: 10.1093/jamiaopen/ooy051
                PMC ID: 6951949
                PubMed ID: 31984347
                SO-VID: 37a100fd-42a0-40ac-8de5-01e72f0a9cf4
                Copyright © © The Author(s) 2018. Published by Oxford University Press on behalf of the American Medical Informatics Association.
                History

                Keywords: International Classification of Diseases,LOINC,SNOMED CT,social determinants of health
                Data availability:
                Keywords: International Classification of Diseases, LOINC, SNOMED CT, social determinants of health

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