Measuring social determinants of health in the All of Us Research Program

Samantha Tesfaye; Robert M Cronin; Maria Lopez-Class; Qingxia Chen; Christopher S Foster; Callie A Gu; Andrew Guide; Robert A Hiatt; Angelica S Johnson; Christine L M Joseph; Parinda Khatri; Sokny Lim; Tamara R Litwin; Fatima A Munoz; Andrea H Ramirez; Heather Sansbury; David G Schlundt; Emma N Viera; Elif Dede-Yildirim; Cheryl R Clark

doi:10.1038/s41598-024-57410-6

Measuring social determinants of health in the All of Us Research Program

Sci Rep. 2024 Apr 16;14(1):8815. doi: 10.1038/s41598-024-57410-6.

Authors

Samantha Tesfaye^{1

2}, Robert M Cronin³, Maria Lopez-Class⁴, Qingxia Chen⁵, Christopher S Foster⁴, Callie A Gu⁶, Andrew Guide⁵, Robert A Hiatt⁷, Angelica S Johnson⁸, Christine L M Joseph⁹, Parinda Khatri¹⁰, Sokny Lim¹¹, Tamara R Litwin¹, Fatima A Munoz¹², Andrea H Ramirez¹¹, Heather Sansbury^{13

14}, David G Schlundt¹⁵, Emma N Viera¹⁶, Elif Dede-Yildirim¹¹, Cheryl R Clark¹⁷

Affiliations

¹ Division of Medical and Scientific Research, All of Us Research Program, National Institutes of Health, Bethesda, MD, USA.
² Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA.
³ Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
⁴ Division of Cohort Development (DCD), All of Us Research Program, National Institutes of Health, Bethesda, MD, USA.
⁵ Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
⁶ Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
⁷ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
⁸ Division of Engagement and Outreach, All of Us Research Program, National Institutes of Health, Bethesda, MD, USA.
⁹ Department of Public Health Sciences, Henry Ford Health, Detroit, MI, USA.
¹⁰ Cherokee Health Systems, Knoxville, TN, USA.
¹¹ Office of Data and Analytics, All of Us Research Program, National Institutes of Health, Bethesda, MD, USA.
¹² Division of Health Support Services, San Ysidro Health, San Diego, CA, USA.
¹³ All of Us Research Program, National Institutes of Health, Bethesda, MD, USA.
¹⁴ Leidos, Inc., Reston, VA, USA.
¹⁵ Department of Psychology, Vanderbilt University, Nashville, TN, USA.
¹⁶ Unlimited Potential, Phoenix, AZ, USA.
¹⁷ Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. crclark@bwh.harvard.edu.

Abstract

To accelerate medical breakthroughs, the All of Us Research Program aims to collect data from over one million participants. This report outlines processes used to construct the All of Us Social Determinants of Health (SDOH) survey and presents the psychometric characteristics of SDOH survey measures in All of Us. A consensus process was used to select SDOH measures, prioritizing concepts validated in diverse populations and other national cohort surveys. Survey item non-response was calculated, and Cronbach's alpha was used to analyze psychometric properties of scales. Multivariable logistic regression models were used to examine associations between demographic categories and item non-response. Twenty-nine percent (N = 117,783) of eligible All of Us participants submitted SDOH survey data for these analyses. Most scales had less than 5% incalculable scores due to item non-response. Patterns of item non-response were seen by racial identity, educational attainment, income level, survey language, and age. Internal consistency reliability was greater than 0.80 for almost all scales and most demographic groups. The SDOH survey demonstrated good to excellent reliability across several measures and within multiple populations underrepresented in biomedical research. Bias due to survey non-response and item non-response will be monitored and addressed as the survey is fielded more completely.

MeSH terms

Health Surveys
Humans
Population Health*
Reproducibility of Results
Social Determinants of Health*
Surveys and Questionnaires

Abstract

MeSH terms

Grants and funding