Social & Behavioral Determinants of Health

Social and Behavioral Determinants of Health

Under the aegis of Dr. William Stead, the Center for Knowledge Management (CKM) partnered with the University of California, San Francisco, to evaluate a panel of measures recommended by the National Academy of Medicine (NAM) committee for capturing patient data on the social and behavioral determinants of health in the clinical setting. The Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and World Health Organization have all identified the social determinants of health as key to the improvement of health outcomes and reduction of health disparities. Research has demonstrated the connection between health outcomes and sociological and behavioral factors such as social connectedness, education level, and exercise habits. However, there is not currently a SBD Imagestandardized method for collecting information on these elements during the clinical encounter.

The NAM committee, assembled in 2013, carefully considered and selected a panel of measures to recommend for clinical use based on their relevance to healthcare, proven validation, and ease of implementation. The CKM has built upon this work to perform the necessary evaluation of the feasibility and validity of administering the identified measures as a combined panel. The study team investigated research questions important to the eventual implementation of the instrument, including considerations of question order and response patterns, time required for administration, and the extent to which questionnaire results align with previous research findings. The goal of this important work is to provide a proven measure to allow clinicians to understand and address social and behavioral influences on patient health.  The team’s results from this study are published in the American Journal of Preventive Medicine.

In Spring 2017, CKM extended the team’s research into the social and behavioral determinants of health.  Through a partnership with a local community health clinic, CKM conducted a pilot study to better understand the type and prevalence of social determinant needs in the community clinic setting, and subsequently used that information to understand the availability and coverage of resources that may help address identified social needs. A database of public health and community-based resources has been created by the CKM team and is available online. Partial results from this pilot study were presented as a poster presentation for the November 2017 annual meeting of the American Medical Informatics Association.

CKM Related Publications


Related CKM Contributions to VUMC Projects


  • William W. Stead, MD, Chief Strategy Information Officer; Professor, Biomedical Informatics
  • Dr. Nancy Adler, Professor, UCSF School of Medicine and Director, UCSF Center for Health and Community
  • Dr. Aric Prather, Professor,  UCSF School of Medicine
  • Laura Gottlieb, Professor, UCSF School of Medicine
  • Suzanne Hurley, Director, Community and Women’s Health Services, Connectus Health