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Health Evaluation TIG Week: The Data Utility of Publicly Available Individual-Level Data Sets Capturing Social Determinants of Health by Shilpa Londhe and Michele Sadler

I’m Shilpa Londhe, a health services research scientist specialized in health equity and maternal health with Deloitte Consulting, LLC.

I’m Michele Sadler, a public health researcher specializing in program evaluation and creating data informed insights for practitioners with Deloitte Consulting, LLC.

We recently spent time reviewing national survey data to better understand how we might study questions related to the social determinants of health (SDOH). SDOH data are critical in identifying and evaluating the scope and magnitude of non-medical experiences which influence health. The SDOH data needs across several types of stakeholders at state, local, and federal levels have been focused on area-level estimates and utilizing disparate sources to co-locate social and health information for analysis. These estimates and data sources have provided significant insight into geospatially identifying communities and areas which have been burdened by persistent disparities in a wide range of health outcomes. However, additional insight can be obtained from leveraging the individual-level longitudinal national data sets which are federally sponsored single-source surveys collecting social and health care information.

Lesson Learned:

National data sets, like the Medical Expenditure Panel Survey (MEPS), National Health and Nutrition Examination Survey (NHANES), and National Health Interview Survey (NHIS) contain self-reported individual-level SDOH data elements and have the potential to capture within year variations in SDOH experiences. These data are transparent in methods and available without a paywall, thereby promoting equitable data access to practitioners and generating additional evidence to inform decision-making at all levels.

Hot Tip:

What to consider when utilizing area-level estimates

  • Data collection tools may lack granularity in questions or data elements being asked or collected
  • The data collected may not be capturing the dynamic nature of the experience
  • The data may not capture the same unit of analysis for the predictor and outcome of interest.

Hot Tip:

How can national data sets be considered for use in your analysis?

  • A robust literature review helping to understand how SDOH in your proposed data set are categorized into social, economic, and environmental domains, while necessary, is not sufficient; rather, identifying specific mechanisms and pathways, direct and indirect, by which SDOH multidimensionally influence a specific outcome (such as health care utilization for chronic conditions) could greatly enhance policy and program evaluation.
  • Once there is a greater understanding of the mechanisms and pathways, the relevant variables can be extracted for analytic use to examine these relationships. We found aligning these variables with the Healthy People 2030 framework to be helpful for the data exploration phase.

The American Evaluation Association is hosting Health Evaluation TIG Week with our colleagues in Health Evaluation Topical Interest Group. The contributions all this week to AEA365 come from our HE TIG members. Do you have questions, concerns, kudos, or content to extend this AEA365 contribution? Please add them in the comments section for this post on the AEA365 webpage so that we may enrich our community of practice. Would you like to submit an AEA365 Tip? Please send a note of interest to AEA365@eval.org. AEA365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators. The views and opinions expressed on the AEA365 blog are solely those of the original authors and other contributors. These views and opinions do not necessarily represent those of the American Evaluation Association, and/or any/all contributors to this site.

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