ArticleJMIR public health and surveillance2023
The Association Between Social Determinants of Health and Population Health Outcomes: Ecological Analysis.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 20 citations in OpenAlex.
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- Bridging the divide in digital therapeutics (DTx): Partnership strategies for broader representation across DTx development and deployment.PLOS digital health · 2026Article
- Exploring the role of place visitation big data on small area health measure estimation.Computational urban science · 2026Article
- Socioeconomic Risk Factors for Extreme Preterm Birth in Hawai'i.Hawai'i journal of health & social welfare · 2025Article
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- MedReadCtrl: Personalizing medical text generation with readability-controlled instruction learning.medRxiv : the preprint server for health sciences · 2025Article
- Explainable machine learning model incorporating social determinants of health to predict chronic kidney disease in type 2 diabetes patients.Journal of diabetes and metabolic disorders · 2025Article
- Is Area-Level Social Vulnerability Index Associated With Patient-Level Health-Related Social Needs in Hand Surgery?The Journal of the American Academy of Orthopaedic Surgeons · 2025Article
- Machine learning to evaluate the relationship between social determinants and diabetes prevalence in New York City.BMJ public health · 2024Article
- Complex patterns and determinants of regional multiple chronic conditions across the United States.PNAS nexus · 2024Article
- Healthcare disparities in pancreatitis: knowledge gaps and next steps.Current opinion in gastroenterology · 2024Review
- Racialized economic segregation and inequities in treatment initiation and survival among patients with metastatic breast cancer.Breast cancer research and treatment · 2024Article
- Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith the increased availability of data, a growing number of studies have been conducted to address the impact of social determinants of health (SDOH) factors on population health outcomes. However, such an impact is either examined at the county level or the state level in the United States. The results of analysis at lower administrative levels would be useful for local policy makers to make informed health policy decisions.
objectiveThis study aimed to investigate the ecological association between SDOH factors and population health outcomes at the census tract level and the city level. The findings of this study can be applied to support local policy makers in efforts to improve population health, enhance the quality of care, and reduce health inequity.
methodsThis ecological analysis was conducted based on 29,126 census tracts in 499 cities across all 50 states in the United States. These cities were grouped into 5 categories based on their population density and political affiliation. Feature selection was applied to reduce the number of SDOH variables from 148 to 9. A linear mixed-effects model was then applied to account for the fixed effect and random effects of SDOH variables at both the census tract level and the city level.
resultsThe finding reveals that all 9 selected SDOH variables had a statistically significant impact on population health outcomes for ≥2 city groups classified by population density and political affiliation; however, the magnitude of the impact varied among the different groups. The results also show that 4 SDOH risk factors, namely, asthma, kidney disease, smoking, and food stamps, significantly affect population health outcomes in all groups (P<.01 or P<.001). The group differences in health outcomes for the 4 factors were further assessed using a predictive margin analysis.
conclusionsThe analysis reveals that population density and political affiliation are effective delineations for separating how the SDOH affects health outcomes. In addition, different SDOH risk factors have varied effects on health outcomes among different city groups but similar effects within city groups. Our study has 2 policy implications. First, cities in different groups should prioritize different resources for SDOH risk mitigation to maximize health outcomes. Second, cities in the same group can share knowledge and enable more effective SDOH-enabled policy transfers for population health.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.