Download PDF
CC BY-NC-ND 4.0 · Yearb Med Inform 2023; 32(01): 253-263
DOI: 10.1055/s-0043-1768732
Section 11: Public Health and Epidemiology Informatics
Survey

Enriching Real-world Data with Social Determinants of Health for Health Outcomes and Health Equity: Successes, Challenges, and Opportunities

Zhe He
1   School of Information, Florida State University, United States
2   Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, United States
,
Emily Pfaff
3   Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, United States
,
Serena Jingchuan Guo
4   Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, United States
,
Yi Guo
5   Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, United States
,
Yonghui Wu
5   Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, United States
,
Cui Tao
6   School of Biomedical Informatics, University of Texas Health Science Center at Houston, United States
,
Gregor Stiglic
7   Faculty of Health Science, University of Maribor, Slovenia
8   Faculty of Electrical Engineering and Computer Science, University of Maribor, Slovenia
9   Usher Institute, University of Edinburgh, UK
,
Jiang Bian
5   Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, United States
› Author Affiliations
› Further Information
   Permissions and Reprints

Summary

Objective: To summarize the recent methods and applications that leverage real-world data such as electronic health records (EHRs) with social determinants of health (SDoH) for public and population health and health equity and identify successes, challenges, and possible solutions.

Methods: In this opinion review, grounded on a social-ecological-model-based conceptual framework, we surveyed data sources and recent informatics approaches that enable leveraging SDoH along with real-world data to support public health and clinical health applications including helping design public health intervention, enhancing risk stratification, and enabling the prediction of unmet social needs.

Results: Besides summarizing data sources, we identified gaps in capturing SDoH data in existing EHR systems and opportunities to leverage informatics approaches to collect SDoH information either from structured and unstructured EHR data or through linking with public surveys and environmental data. We also surveyed recently developed ontologies for standardizing SDoH information and approaches that incorporate SDoH for disease risk stratification, public health crisis prediction, and development of tailored interventions.

Conclusions: To enable effective public health and clinical applications using real-world data with SDoH, it is necessary to develop both non-technical solutions involving incentives, policies, and training as well as technical solutions such as novel social risk management tools that are integrated into clinical workflow. Ultimately, SDoH-powered social risk management, disease risk prediction, and development of SDoH tailored interventions for disease prevention and management have the potential to improve population health, reduce disparities, and improve health equity.

Keywords

Social determinants of health - public health informatics - electronic health records - exposome


Publication History

Article published online:
26 December 2023

© 2023. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep Wash DC 1974 2014;129 Suppl 2:19–31. doi: 10.1177/00333549141291S206.
    PubMed
  • 2 WHO. Social determinants of health n.d. https://www.who.int/health-topics/social-determinants-of-health (accessed January 29, 2023).
    PubMed
  • 3 McGinnis JM, Williams-Russo P, Knickman JR. The case for more active policy attention to health promotion. Health Aff Proj Hope 2002;21:78–93. doi: 10.1377/hlthaff.21.2.78.
    PubMed
  • 4 McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA 1993;270:2207–12.
    PubMed
  • 5 Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJL, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med 2009;6:e1000058. doi: 10.1371/journal.pmed.1000058.
    PubMed
  • 6 Social Determinants of Health - Healthy People 2030 n.d. https://health.gov/healthypeople/priority-areas/social-determinants-health (accessed February 5, 2023).
    PubMed
  • 7 What are the Social Determinants of Health? Natl Acad Med n.d. https://nam.edu/programs/culture-of-health/young-leaders-visualize-health-equity/what-are-the-social-determinants-of-health/ (accessed February 5, 2023).
    PubMed
  • 8 Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records, Board on Population Health and Public Health Practice, Institute of Medicine. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington (DC): National Academies Press (US); 2015.
    PubMed
  • 9 WHO. Health Equity Status Report initiative n.d. https://www.who.int/europe/initiatives/health-equity-status-report-initiative (accessed April 25, 2023).
    PubMed
  • 10 Buzeti T, Madureira Lima J, Yang L, Brown C. Leaving no one behind: health equity as a catalyst for the sustainable development goals. Eur J Public Health 2020;30:i24–7. doi: 10.1093/eurpub/ckaa033.
    PubMed
  • 11 Annis R, Beattie M, Racher FF. Rural Community Health and Well-Being: A Guide to Action; 2004.
    PubMed
  • 12 Saydah S, Bullard KM, Chen Y, Ali MK, Gregg EW, Geiss L, et al. Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999-2010. Obes Silver Spring Md 2014;22:1888–95. doi: 10.1002/oby.20761.
    PubMed
  • 13 Husk K, Elston J, Gradinger F, Callaghan L, Asthana S. Social prescribing: where is the evidence? Br J Gen Pract 2019;69:6–7. doi: 10.3399/bjgp19X700325.
    PubMed
  • 14 Hill-Briggs F, Ephraim PL, Vrany EA, Davidson KW, Pekmezaris R, Salas-Lopez D, et al. Social Determinants of Health, Race, and Diabetes Population Health Improvement: Black/African Americans as a Population Exemplar. Curr Diab Rep 2022;22:117–28. doi: 10.1007/s11892-022-01454-3.
    PubMed
  • 15 Ogunwole SM, Golden SH. Social Determinants of Health and Structural Inequities-Root Causes of Diabetes Disparities. Diabetes Care 2021;44:11–3. doi: 10.2337/dci20-0060.
    PubMed
  • 16 Guo Y, Bian J, Wang F. Editorial: Measuring and Analysing Social Determinants of Health in the Era of Big Data. Front Public Health 2022;10:902942. doi: 10.3389/fpubh.2022.902942.
    PubMed
  • 17 Guo Y, Chen Z, Xu K, George TJ, Wu Y, Hogan W, et al. International Classification of Diseases, Tenth Revision, Clinical Modification social determinants of health codes are poorly used in electronic health records. Medicine (Baltimore) 2020;99:e23818. doi: 10.1097/MD.0000000000023818.
    PubMed
  • 18 Patra BG, Sharma MM, Vekaria V, Adekkanattu P, Patterson OV, Glicksberg B, et al. Extracting social determinants of health from electronic health records using natural language processing: a systematic review. J Am Med Inform Assoc 2021;28:2716–27. doi: 10.1093/jamia/ocab170.
    PubMed
  • 19 Yu Z, Yang X, Dang C, Wu S, Adekkanattu P, Pathak J, et al. A Study of Social and Behavioral Determinants of Health in Lung Cancer Patients Using Transformers-based Natural Language Processing Models. AMIA Annu Symp Proc 2021:1225–33.
    PubMed
  • 20 Zhang H, Hu H, Diller M, Hogan WR, Prosperi M, Guo Y, et al. Semantic standards of external exposome data. Environ Res 2021;197:111185. doi: 10.1016/j.envres.2021.111185.
    PubMed
  • 21 Dang Y, Li F, Hu X, Keloth VK, Zhang M, Fu S, et al. Systematic Design and Evaluation of Social Determinants of Health Ontology (SDoHO) 2022. doi: 10.48550/arXiv.2212.01941.
    PubMed
  • 22 Guo SJ, Shao H. Growing global burden of type 1 diabetes needs multitiered precision public health interventions. Lancet Diabetes Endocrinol 2022;10:688–9. doi: 10.1016/S2213-8587(22)00257-1.
    PubMed
  • 23 He Z, Tao C, Bian J, Dumontier M, Hogan WR. Semantics-Powered Healthcare Engineering and Data Analytics. J Healthc Eng 2017;2017:e7983473. doi: 10.1155/2017/7983473.
    PubMed
  • 24 Amith M, He Z, Bian J, Lossio-Ventura JA, Tao C. Assessing the practice of biomedical ontology evaluation: Gaps and opportunities. J Biomed Inform 2018;80:1–13. doi: 10.1016/j.jbi.2018.02.010.
    PubMed
  • 25 Fecho K, Pfaff E, Xu H, Champion J, Cox S, Stillwell L, et al. A novel approach for exposing and sharing clinical data: the Translator Integrated Clinical and Environmental Exposures Service. J Am Med Inform Assoc 2019;26:1064–73. doi: 10.1093/jamia/ocz042.
    PubMed
  • 26 Kopitar L, Kocbek P, Cilar L, Sheikh A, Stiglic G. Early detection of type 2 diabetes mellitus using machine learning-based prediction models. Sci Rep 2020;10:11981. doi: 10.1038/s41598-020-68771-z.
    PubMed
  • 27 Fecho K, Ahalt SC, Knowles M, Krishnamurthy A, Leigh M, Morton K, et al. Leveraging Open Electronic Health Record Data and Environmental Exposures Data to Derive Insights Into Rare Pulmonary Disease. Front Artif Intell 2022;5:918888. doi: 10.3389/frai.2022.918888.
    PubMed
  • 28 Fecho K, Ahalt SC, Appold S, Arunachalam S, Pfaff E, Stillwell L, et al. Development and Application of an Open Tool for Sharing and Analyzing Integrated Clinical and Environmental Exposures Data: Asthma Use Case. JMIR Form Res 2022;6:e32357. doi: 10.2196/32357.
    PubMed
  • 29 Pfaff ER, Madlock-Brown C, Baratta JM, Bhatia A, Davis H, Girvin A, et al. Coding long COVID: characterizing a new disease through an ICD-10 lens. BMC Med 2023;21:58. doi: 10.1186/s12916-023-02737-6.
    PubMed
  • 30 CDC. The Social-Ecological Model: A Framework for Prevention 2022. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html (accessed February 12, 2023).
    PubMed
  • 31 NIMHD. The NIMHD Minority Health and Health Disparities Research Framework. NIMHD n.d. https://www.nimhd.nih.gov/about/overview/research-framework/nimhd-framework.html (accessed February 12, 2023).
    PubMed
  • 32 Wang M, Pantell MS, Gottlieb LM, Adler-Milstein J. Documentation and review of social determinants of health data in the EHR: measures and associated insights. J Am Med Inform Assoc 2021;28:2608–16. doi: 10.1093/jamia/ocab194.
    PubMed
  • 33 Arons A, DeSilvey S, Fichtenberg C, Gottlieb L. Documenting social determinants of health-related clinical activities using standardized medical vocabularies. JAMIA Open 2019;2:81–8. doi: 10.1093/jamiaopen/ooy051.
    PubMed
  • 34 National Association of Community Health Centers. PRAPARE: Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences n.d. https://www.in.gov/health/cdpc/files/PRAPARE_Assessment_Tool.pdf (accessed January 16, 2023).
    PubMed
  • 35 Billioux A, Verlander K, Anthony S, Alley D. Standardized Screening for Health-Related Social Needs in Clinical Settings: The Accountable Health Communities Screening Tool. NAM Perspect 2017. doi: 10.31478/201705b.
    PubMed
  • 36 The Health Leads Screening Toolkit. Health Leads n.d. https://healthleadsusa.org/resources/the-health-leads-screening-toolkit/ (accessed January 29, 2023).
    PubMed
  • 37 SEEK Parent Questionnaire n.d. https://seekwellbeing.org/wp-content/uploads/2022/10/SEEK-PQ-R-English-9-22.pdf (accessed January 29, 2023).
    PubMed
  • 38 Garg A, Toy S, Tripodis Y, Silverstein M, Freeman E. Addressing social determinants of health at well child care visits: a cluster RCT. Pediatrics 2015;135:e296-304. doi: 10.1542/peds.2014-2888.
    PubMed
  • 39 Freij M, Dullabh P, Lewis S, Smith SR, Hovey L, Dhopeshwarkar R. Incorporating Social Determinants of Health in Electronic Health Records: Qualitative Study of Current Practices Among Top Vendors. JMIR Med Inform 2019;7:e13849. doi: 10.2196/13849.
    PubMed
  • 40 Walters K, Clark M, Dard S, et al. N3C data enhancements: A path for expanding common data models. AMIA Summits Transl Sci Proc. Forthcoming 2023.
    PubMed
  • 41 Camacho-Rivera M, Islam JY, Vidot DC, Espinoza J, Galiatsatos P, Sule A, et al. Social Determinants of Health During the COVID-19 Pandemic in the US: Precision Through Context. In: Hsueh P-YS, Wetter T, Zhu X, editors. Personal Health Informatics. Patient Participation in Precisision Health. Cham: Springer International Publishing; 2022. p. 397–425. doi: 10.1007/978-3-031-07696-1_19.
    PubMed
  • 42 Nour N, Stuckler D, Ajayi O, Abdalla ME. Effectiveness of alternative approaches to integrating SDOH into medical education: a scoping review. BMC Med Educ 2023;23:18. doi: 10.1186/s12909-022-03899-2.
    PubMed
  • 43 American Hospital Association. ICD-10-CM Coding for Social Determinants and Health n.d. https://www.aha.org/system/files/2018-04/value-initiative-icd-10-code-social-determinants-of-health.pdf (accessed January 16, 2023).
    PubMed
  • 44 Yan AF, Chen Z, Wang Y, Campbell JA, Xue Q-L, Williams MY, et al. Effectiveness of Social Needs Screening and Interventions in Clinical Settings on Utilization, Cost, and Clinical Outcomes: A Systematic Review. Health Equity 2022;6:454–75. doi: 10.1089/heq.2022.0010.
    PubMed
  • 45 Abiri A, Evans DD, Hamilton JB. Strategies to Integrate the Practice of Social Emergency Medicine Into Routine Patient Care. Adv Emerg Nurs J 2022;44:78–83. doi: 10.1097/TME.0000000000000409.
    PubMed
  • 46 Yetisgen M, Vanderwende L. Automatic Identification of Substance Abuse from Social History in Clinical Text. In: ten Teije A, Popow C, Holmes JH, Sacchi L, editors. Artif. Intell. Med., Cham: Springer International Publishing; 2017, p. 171–81. doi: 10.1007/978-3-319-59758-4_18.
    PubMed
  • 47 Gundlapalli AV, Carter ME, Palmer M, Ginter T, Redd A, Pickard S, et al. Using natural language processing on the free text of clinical documents to screen for evidence of homelessness among US veterans. AMIA Annu Symp Proc 2013;2013:537–46.
    PubMed
  • 48 Hatef E, Rouhizadeh M, Nau C, Xie F, Rouillard C, Abu-Nasser M, et al. Development and assessment of a natural language processing model to identify residential instability in electronic health records' unstructured data: a comparison of 3 integrated healthcare delivery systems. JAMIA Open 2022;5:ooac006. doi: 10.1093/jamiaopen/ooac006.
    PubMed
  • 49 Dillahunt-Aspillaga C, Finch D, Massengale J, Kretzmer T, Luther SL, McCart JA. Using information from the electronic health record to improve measurement of unemployment in service members and veterans with mTBI and post-deployment stress. PloS One 2014;9:e115873. doi: 10.1371/journal.pone.0115873.
    PubMed
  • 50 Fernandes AC, Dutta R, Velupillai S, Sanyal J, Stewart R, Chandran D. Identifying Suicide Ideation and Suicidal Attempts in a Psychiatric Clinical Research Database using Natural Language Processing. Sci Rep 2018;8:7426. doi: 10.1038/s41598-018-25773-2.
    PubMed
  • 51 Feller DJ, Bear Don't Walk Iv OJ, Zucker J, Yin MT, Gordon P, Elhadad N. Detecting Social and Behavioral Determinants of Health with Structured and Free-Text Clinical Data. Appl Clin Inform 2020;11:172–81. doi: 10.1055/s-0040-1702214.
    PubMed
  • 52 Lybarger K, Ostendorf M, Yetisgen M. Annotating social determinants of health using active learning, and characterizing determinants using neural event extraction. J Biomed Inform 2021;113:103631. doi: 10.1016/j.jbi.2020.103631.
    PubMed
  • 53 Han S, Zhang RF, Shi L, Richie R, Liu H, Tseng A, et al. Classifying social determinants of health from unstructured electronic health records using deep learning-based natural language processing. J Biomed Inform 2022;127:103984. doi: 10.1016/j.jbi.2021.103984.
    PubMed
  • 54 Stemerman R, Arguello J, Brice J, Krishnamurthy A, Houston M, Kitzmiller R. Identification of social determinants of health using multi-label classification of electronic health record clinical notes. JAMIA Open 2021;4:ooaa069. doi: 10.1093/jamiaopen/ooaa069.
    PubMed
  • 55 National NLP Clinical Challenges (n2c2) Track 2 Extracting Social Determinants of Health n.d. https://n2c2.dbmi.hms.harvard.edu/2022-track-2 (accessed February 5, 2023).
    PubMed
  • 56 Yu Z, Yang X, Dang C, Adekkanattu P, Patra BG, Peng Y, et al. SODA: A Natural Language Processing Package to Extract Social Determinants of Health for Cancer Studies 2022. doi: 10.48550/arXiv.2212.03000.
    PubMed
  • 57 Kolak M, Bhatt J, Park YH, Padrón NA, Molefe A. Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States. JAMA Netw Open 2020;3:e1919928. doi: 10.1001/jamanetworkopen.2019.19928.
    PubMed
  • 58 World Health Organization. A conceptual framework for action on the social determinants of health. World Health Organization; 2010. https://apps.who.int/iris/rest/bitstreams/52952/retrieve (accessed May 2, 2023)
    PubMed
  • 59 Wild CP. Complementing the genome with an “exposome”: the outstanding challenge of environmental exposure measurement in molecular epidemiology. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 2005;14:1847–50. doi: 10.1158/1055-9965.EPI-05-0456.
    PubMed
  • 60 US Census Bureau. American Community Survey (ACS). CensusGov n.d. https://www.census.gov/programs-surveys/acs (accessed February 10, 2023).
    PubMed
  • 61 How Healthy is your County? | County Health Rankings. Cty Health Rank Roadmaps n.d. https://www.countyhealthrankings.org/county-health-rankings-roadmaps (accessed February 10, 2023).
    PubMed
  • 62 USDA ERS - Food Environment Atlas n.d. https://www.ers.usda.gov/data-products/food-environment-atlas/ (accessed February 10, 2023).
    PubMed
  • 63 Hu H, Zheng Y, Wen X, Smith SS, Nizomov J, Fishe J, et al. An external exposome-wide association study of COVID-19 mortality in the United States. Sci Total Environ 2021;768:144832. doi: 10.1016/j.scitotenv.2020.144832.
    PubMed
  • 64 Hu H, Zhao J, Savitz DA, Prosperi M, Zheng Y, Pearson TA. An external exposome-wide association study of hypertensive disorders of pregnancy. Environ Int 2020;141:105797. doi: 10.1016/j.envint.2020.105797.
    PubMed
  • 65 Juarez PD, Matthews-Juarez P. Applying an Exposome-Wide (ExWAS) Approach to Cancer Research. Front Oncol 2018;8:313. doi: 10.3389/fonc.2018.00313.
    PubMed
  • 66 Kingsbury P, Abajian H, Abajian M, Angyan P, Espinoza J, MacDonald B, et al. SEnDAE: A Resource for Expanding Research into Social and Environmental Determinants of Health. Comput Methods Programs Biomed 2023:107542. doi: 10.1016/j.cmpb.2023.107542.
    PubMed
  • 67 Hu H, Liu X, Zheng Y, He X, Hart J, James P, et al. Methodological challenges in spatial and contextual exposome-health studies. Crit Rev Environ Sci Technol 2022;0:1–20. doi: 10.1080/10643389.2022.2093595.
    PubMed
  • 68 Hicks A, Hanna J, Welch D, Brochhausen M, Hogan WR. The ontology of medically related social entities: recent developments. J Biomed Semant 2016;7:47. doi: 10.1186/s13326-016-0087-8.
    PubMed
  • 69 Phan N, Dou D, Wang H, Kil D, Piniewski B. Ontology-based deep learning for human behavior prediction with explanations in health social networks. Inf Sci 2017;384:298–313. doi: 10.1016/j.ins.2016.08.038.
    PubMed
  • 70 Buttigieg PL, Pafilis E, Lewis SE, Schildhauer MP, Walls RL, Mungall CJ. The environment ontology in 2016: bridging domains with increased scope, semantic density, and interoperation. J Biomed Semant 2016;7:57. doi: 10.1186/s13326-016-0097-6.
    PubMed
  • 71 Viet SM, Falman JC, Merrill LS, Faustman EM, Savitz DA, Mervish N, et al. Human Health Exposure Analysis Resource (HHEAR): A model for incorporating the exposome into health studies. Int J Hyg Environ Health 2021;235:113768. doi: 10.1016/j.ijheh.2021.113768.
    PubMed
  • 72 Balshaw DM, Collman GW, Gray KA, Thompson CL. The Children's Health Exposure Analysis Resource: enabling research into the environmental influences on children's health outcomes. Curr Opin Pediatr 2017;29:385–9. doi: 10.1097/MOP.0000000000000491.
    PubMed
  • 73 Chan LE, Thessen AE, Duncan WD, Matentzoglu N, Schmitt C, Grondin CJ, et al. The Environmental Conditions, Treatments, and Exposures Ontology (ECTO): connecting toxicology and exposure to human health and beyond. J Biomed Semantics. 2023;14(1):3. doi: 10.1186/s13326-023-00283-x.
    PubMed
  • 74 Rousseau JF, Oliveira E, Tierney WM, Khurshid A. Methods for development and application of data standards in an ontology-driven information model for measuring, managing, and computing social determinants of health for individuals, households, and communities evaluated through an example of asthma. J Biomed Inform 2022;136:104241. doi: 10.1016/j.jbi.2022.104241.
    PubMed
  • 75 Kollapally NM, Chen Y, Xu J, Geller J. An Ontology for the Social Determinants of Health Domain, IEEE Computer Society; 2022. p. 2403–10. doi: 10.1109/BIBM55620.2022.9995544.
    PubMed
  • 76 Hastings J. Achieving Inclusivity by Design: Social and Contextual Information in Medical Knowledge. Yearb Med Inform 2022;31:228–35. doi: 10.1055/s-0042-1742509.
    PubMed
  • 77 Michie S, West R, Finnerty AN, Norris E, Wright AJ, Marques MM, et al. Representation of behaviour change interventions and their evaluation: Development of the Upper Level of the Behaviour Change Intervention Ontology. Wellcome Open Res 2020;5:123. doi: 10.12688/wellcomeopenres.15902.2.
    PubMed
  • 78 Figueroa JF, Frakt AB, Jha AK. Addressing Social Determinants of Health: Time for a Polysocial Risk Score. JAMA 2020;323:1553–4. doi: 10.1001/jama.2020.2436.
    PubMed
  • 79 He Y, Lakhani CM, Rasooly D, Manrai AK, Tzoulaki I, Patel CJ. Comparisons of Polyexposure, Polygenic, and Clinical Risk Scores in Risk Prediction of Type 2 Diabetes. Diabetes Care 2021;44:935–43. doi: 10.2337/dc20-2049.
    PubMed
  • 80 Hu H, Zhao J, Bian J, Zheng Y, Pearson TA. Abstract P428: A Polyexposomic Risk Score for Hypertensive Disorders of Pregnancy Using External Exposome Data. Circulation 2020;141:AP428–AP428. doi: 10.1161/circ.141.suppl_1.P428.
    PubMed
  • 81 Guo J, Hu H, Zheng Y, Guo Y, Chen A, Magnani JW, et al. Abstract 003: Contextual- And Personal-level Social Determinants Of Health And Real-world Adoption Of Novel Treatments For Improving Cardiovascular Outcomes In Type 2 Diabetes. Circulation 2022;145:A003–A003. doi: 10.1161/circ.145.suppl_1.003.
    PubMed
  • 82 Gao W, Leighton C, Chen Y, Jones J, Mistry P. Predicting opioid use disorder and associated risk factors in a Medicaid managed care population. Am J Manag Care 2021;27:148–54. doi: 10.37765/ajmc.2021.88617.
    PubMed
  • 83 Mitra A, Ahsan H, Li W, Liu W, Kerns RD, Tsai J, et al. Risk Factors Associated With Nonfatal Opioid Overdose Leading to Intensive Care Unit Admission: A Cross-sectional Study. JMIR Med Inform 2021;9:e32851. doi: 10.2196/32851.
    PubMed
  • 84 Transportation to Support Rural Healthcare Overview - Rural Health Information Hub n.d. https://www.ruralhealthinfo.org/topics/transportation (accessed February 10, 2023).
    PubMed
  • 85 Prosperi M, Guo Y, Sperrin M, Koopman JS, Min JS, He X, et al. Causal inference and counterfactual prediction in machine learning for actionable healthcare. Nat Mach Intell 2020;2:369–75. doi: 10.1038/s42256-020-0197-y.
    PubMed
  • 86 Tang H, Wu Y, Brown J, Anton S, Hernandez I, Bian J, Guo J. Heterogeneous effect of social and behavioral determinants of health on the risk of dementia. Alzheimers Dement 2022;19:e063752.
    PubMed
  • 87 Gold R, Bunce A, Cowburn S, Dambrun K, Dearing M, Middendorf M, et al. Adoption of Social Determinants of Health EHR Tools by Community Health Centers. Ann Fam Med 2018;16:399–407. doi: 10.1370/afm.2275.
    PubMed
  • 88 Chen M, Tan X, Padman R. Social determinants of health in electronic health records and their impact on analysis and risk prediction: A systematic review. J Am Med Inform Assoc 2020;27:1764–73. doi: 10.1093/jamia/ocaa143.
    PubMed
  • 89 Cossio M. Digital social determinants of health 2023. doi: 10.33774/coe-2023-xvh49. (working paper, non peer reviewed).
    PubMed
  • 90 Foell S, Phithakkitnukoon S, Kortuem G, Veloso M, Bento C. Catch me if you can: Predicting mobility patterns of public transport users. Proceedings of the 17th International IEEE Conference on Intelligent Transportation Systems; 2014. p. 1995–2002. doi: 10.1109/ITSC.2014.6957997.
    PubMed
  • 91 Costa C, Ha J, Lee S. Spatial disparity of income-weighted accessibility in Brazilian Cities: Application of a Google Maps API. J Transp Geogr 2021;90:102905. doi: 10.1016/j.jtrangeo.2020.102905.
    PubMed
  • 92 Kök İ, Şimşek MU, Özdemir S. A deep learning model for air quality prediction in smart cities. Proceedings of the IEEE International Conference on Big Data; 2017. p. 1983–90. doi: 10.1109/BigData.2017.8258144.
    PubMed
  • 93 Ludvigsson JF, Svedberg P, Olén O, Bruze G, Neovius M. The longitudinal integrated database for health insurance and labour market studies (LISA) and its use in medical research. Eur J Epidemiol 2019;34:423–37. doi: 10.1007/s10654-019-00511-8.
    PubMed