Advancing the Understanding of Social Determinants of Health Through Geospatial Analysis

Excerpt

Social determinants of health, such as neighborhood characteristics and residential segregation, are increasingly recognized as factors significantly influencing health outcomes and contributing to inequities in health.1 ^, 2 As health care systems are asked to address the social and environmental factors influencing their patients, a better understanding of the relationship between different social determinants of health and outcomes is necessary. In this issue of JGIM, Nelson et al. examine the association between neighborhood socioeconomic status (NSES) and all-cause mortality in a national sample of veterans.3 Using Veteran Health Administration (VHA) data on individual veteran characteristics and US Census Bureau data on census tract characterized NSES, Nelson et al. found those in the lowest (poorest) decile were 10% more likely to die than those living in the highest (wealthiest) decile, after adjustment for socio-demographics, individual income, and comorbidities.3 The authors should be commended for their analysis incorporating available spatial information and a national sample of veterans, addressing limitations of prior studies by using a population with racial/ethnic and income diversity and simultaneously adjusting for individual comorbidities and socioeconomic factors.3 …