Enhancing outcomes for geriatric patients with evaluation of the social determinants of health.

Relationship between social determinants of health and hip fracture in the American population: a cross-sectional NHANES study.

Expanding Implementation of a Social Determinants of Health Screening and Referral Program to Community-Based Pediatric Clinics.

Social determinants of health (SDoH), including poverty and social isolation, have emerged as important contributors to adverse outcomes of chronic diseases. However, their impact on patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains poorly characterised. This study aimed to assess the association between social vulnerability in MASLD and liver-related and cardiovascular outcomes. We conducted a population-based retrospective cohort study using the TriNetX network, which aggregates de-identified electronic health records from healthcare systems across the U.S. Patients with MASLD and at least one International Classification of Diseases, Tenth Revision (ICD-10) code for documented social vulnerability (Z59.5, Z59.6, Z56.0 and Z60.2) were compared to non-socially vulnerable individuals. Outcomes, including major adverse liver outcomes (MALO), major adverse cardiovascular events (MACE), hepatocellular carcinoma (HCC) and other cardiovascular complications, were assessed over a 5-year follow-up using Cox proportional hazards models. Individuals with MASLD and documented social vulnerability were at higher risk of MALO (8.3% vs. 4.4%; HR 1.69, 95% CI: 1.42-2.01). Cardiovascular morbidity was consistently elevated including MACE (22.7% vs. 12.5%; HR 1.64, 95% CI: 1.46-1.83), arrhythmias (34.4% vs. 17.8%; HR 1.81, 95% CI: 1.64-2.00) and heart failure (12.4% vs. 6.7%; HR 1.64, 95% CI: 1.42-1.89). The incidence of HCC did not differ between documented socially vulnerable and non-socially vulnerable individuals with MASLD. Documented social vulnerability is independently associated with higher risks of liver and cardiovascular complications in MASLD. These findings underscore the importance of integrating SDoH into MASLD management and risk prediction models to address disparities in long-term outcomes.

Abuse in individuals with multiple sclerosis: the SocialMS Italian study.

Introduction. Although the use of telemedicine appointments has grown exponentially since the COVID-19 pandemic, missed telemedicine appointments remain a relatively understudied topic. We set out to develop and validate a predictive model to identify patients at high risk of missing telemedicine appointments. Methods. Retrospective cohort. We included telemedicine appointments from August 1, 2020, to March 31, 2021. We included as predictors the clinical characteristics of the patients, missed appointment history, appointment characteristics, social determinants of health, and weather conditions. We developed a predictive model using multivariate mixed-effects logistic regression Results. We included 3339 telemedicine appointments, with a missed appointment rate of 11.35% (95%CI 10.3-12.5). Among the risk factors for missing telemedicine appointments, we found that public health coverage (OR 2.2) and having other appointments on the same day (OR 3.2) increased the likelihood of missing telemedicine appointments. On the other hand, having a chronic condition (OR 0.5) and the number of previous appointments requested (OR 0.7) acted as protective factors. The final predictive model included 19 variables and 4 interactions, with an area under the ROC curve of 0.72 (95%CI 0.70.8) and a calibration slope of 0.78 (95%CI 0.6-0.9), indicating slight overfitting. Conclusion. In this study, we developed and validated a predictive model that identifies children at high risk of missing telemedicine appointments. This model helps guide strategies aimed at reducing missed telemedicine appointments.

Effects of socioeconomic status on outcomes in <15% TBSA pediatric burn injuries: A single-institution retrospective study.

Health data linkage systems are essential for understanding and addressing health inequalities, yet the US system—already constrained by legal and institutional limitations—has been further eroded by the second Trump administration's policies. These include defunding data collection, politicizing inequality-related research, and breaching privacy rules that protect personal data. This article draws on documentary analysis, secondary data, and comparative institutional review to document recent changes to US health data infrastructure and evaluate alternative models from France, Sweden, and England. The authors find that the Trump administration's actions have severely undermined the US health data linkage system, disrupting the production of data and undermining public trust. A centralized system like Sweden's offers broad data linkage capacity but may not be feasible in the United States because of privacy concerns. France's tight controls on access limit usability to elite analysts, exacerbating inequality. England's nascent system offers a model for equitable access to data on social, economic, and political determinants of health. Rebuilding the US health data linkage infrastructure after Trump will require restoring public trust, restoring collection of key sociodemographic indicators, and ensuring equity in access. International examples provide guidance for a more politically sustainable, inclusive system.

A cross-sectional cohort study of menopause-related symptoms in British Columbia.

Determinants of colonoscopy adherence after positive colorectal cancer screening: Insights from individual and municipality-level data in Flanders.

Unpacking asthma risks: A multi-level spatial analysis of social determinants of health in the U.S.

Despite ongoing advancements in prevention and treatment strategies, socioeconomic disparities in infectious diseases remain widespread across the United States and continue to disproportionately affect vulnerable communities. The COVID-19 pandemic brought attention to these issues of place-specific structural predisposition related to poverty, density of housing, inadequate medical care, and digital divides, which determine both disease exposure and mortality. The present narrative literature review aggregates knowledge from geospatial analytics (GA) solutions aimed at understanding and remediating these issues. Drawing from spatial epidemiology, geographic information systems (GIS), geospatial statistics techniques, ML-GIS hybrids, and GA optimization models, this review highlights how geospatial tools can be utilized to define infectious disease burden clustering in geographically stratified areas and to visualize disease burden gradients from rural to urban areas. Infectious disease burden data, coupled with advancements from remote sensing imagery and high-resolution ML models, have led to distinct increases in accuracy to accurately target infectious disease burden areas related to vaccination and rural preparedness planning; these areas can be utilized to prevent unacceptable infectious disease burden risks for anyone. Despite these advancements and ongoing research efforts, issues persist regarding data deserts, privacy issues related to geoprofiling techniques, heterogeneity in geospatial data models, and techniques related to infectious disease burden research study experiments in rural public health organizations across areas related to geospatial data storage requirements. A geospatial analytics solution inclusive and oriented towards equity can be transformative in enabling precision public health approaches directed towards disrupting infectious disease burden inequity rather than perpetuating issues of inequity. Keywords: Geospatial Analytics, Infectious Disease Disparities, Social Determinants of Health

Evidence on how poverty and social determinants influence adverse maternal and perinatal outcomes in the UK is limited. While ethnicity and area-level deprivation are well described, fewer studies examine the cumulative impact of poverty-related factors such as low income, employment insecurity, housing, and access to social support. We analysed 67,308 pregnancies from the eLIXIR cohort using linked NHS records. Social determinants were defined using the WHO framework as structural (ethnicity, migration status, area deprivation) and intermediary (housing, employment, financial hardship, social support, barriers to care). The primary outcome was a composite adverse perinatal outcome. Binary logistic regression models with random intercepts accounted for repeated pregnancies, and adjusted risk ratios (aRRs) were estimated controlling for key sociodemographic and clinical factors. Structural poverty-related social determinants of health were associated with increased risk of adverse perinatal outcomes, including Black (aRR 1.50, 95% CI 1.42-1.59), Asian (aRR 1.49, 95% CI 1.39-1.59), and other minoritised ethnic backgrounds (aRR 1.50, 95% CI 1.42-1.59), residence in the most deprived areas (aRR 1.10, 95% CI 1.01-1.20), non-UK birth (aRR 1.20, 95% CI 1.15-1.25), and recent migration (aRR 1.32, 95% CI 1.14-1.53). Intermediary poverty-related social determinants of health were independently associated with increased risk beyond ethnicity and deprivation, including lack of social support (aRR 1.21, 95% CI 1.02-1.42), unemployment (aRR 1.16, 95% CI 1.10-1.23), financial hardship (aRR 1.17, 95% CI 1.01-1.35), living in social housing (aRR 1.16, 95% CI 1.09-1.24), transfer of care between hospitals (aRR 1.27, 95% CI 1.18-1.37), missed appointments (aRR 1.19, 95% CI 1.04-1.37), and unscheduled maternity care use (aRR 1.21, 95% CI 1.14-1.29). Women exposed to multiple overlapping poverty-related social determinants of health had a substantially higher likelihood of adverse perinatal outcomes (aRR 1.23, 95% CI 1.12-1.35). Structural and intermediary social determinants related to poverty have a substantial and cumulative impact on maternal and perinatal outcomes, independent of individual clinical risk. Addressing these inequities requires integrated, cross-sector strategies that extend beyond healthcare to the wider social conditions influencing maternal and child health. Not applicable.

Voting is increasingly acknowledged as a social determinant of health. Voter turnout is correlated with self-reported health and influences other social determinants, such as housing and education. Vot-ER, a nonprofit, nonpartisan organization, focuses on promoting voter engagement within health care settings. This article details a strategy implemented at a large academic medical center to encourage voter registration among both patients and staff. Two internal medicine physicians, after completing the Vot-ER Civic Health Fellowship, utilized existing academic platforms, specifically Grand Rounds presentations to various departments, to emphasize the importance of civic health and introduce Vot-ER tools. This approach successfully engaged colleagues and established a network of health care providers dedicated to voter engagement. To evaluate the initiative, institution-specific QR codes on Vot-ER badge cards were tracked. Between June 2022 and October 2025, 1,282 badge scans resulted in 489 voter registrations. Building on this success and in alignment with the Association of American Medical Colleges' guidance, an official Vot-ER student organization was formed in September 2023 to further increase voter registration and policy awareness among students and staff. Key lessons learned include the importance of understanding institutional culture and leveraging personal relationships to gain support and legitimacy for such initiatives. This strategy demonstrates a practical approach to integrating civic health into health care practice, with implications for improving community health outcomes through increased voter participation.

Adolescent mental health is a growing concern in the United States. Promoting health equity through addressing social determinants of health (SDOH) is a national priority and aligns with the Social Work Grand Challenge to "close the health gap." School-based mental health services (SBMHS) provide interdisciplinary support to enhance students' emotional, behavioral, and social functioning. This study analyzed data from 12th-grade participants in the 2022 and 2023 Monitoring the Future surveys-an annual, nationally representative, cross-sectional study-to (a) identify SDOH associated with depressive symptoms and happiness among high school seniors and (b) assess the influence of SBMHS on these outcomes. Two hierarchical regression analyses (n = 2,574 for depressive symptoms; n = 2,844 for happiness) revealed that attending schools in medium-sized cities (versus small cities) and having more friends using substances were social determinants associated with both higher depressive symptoms and lower happiness. Higher parental educational attainment and living with both parents were protective social determinants specific to depressive symptoms. SBMHS were significantly associated with reduced depressive symptoms and enhanced happiness. These findings highlight the importance of addressing social determinants of adolescent mental health and advocate for expanding SBMHS.

Stroke is the leading cause of aphasia, disproportionately impacting racially and ethnically diverse populations. With the aging and diversification of the U.S. population, stroke-related aphasia prevalence is expected to rise significantly. This article estimates projected prevalence trends of poststroke aphasia through 2050, focusing explicitly on racial/ethnic differences and contributing social determinants of health (SDOH). This article synthesizes national epidemiological data on stroke prevalence, integrating population projections from the U.S. Census Bureau and public health sources to assess the expected rise in aphasia across racial and ethnic groups. A brief review of literature on SDOH, including socioeconomic status, health care access, and neighborhood factors, is included to contextualize disparities observed in projected aphasia prevalence. The findings demonstrate significant disparities in stroke and aphasia prevalence across different racial and ethnic groups. Specifically, by 2050, poststroke aphasia cases are projected to nearly double, with the Black population expected to have the highest prevalence rate among all racial and ethnic groups. These trends are driven by demographic shifts, including the aging population and racial/ethnic diversification. The findings highlight the need for targeted health care interventions that address disparities rooted in SDOH affecting stroke and aphasia care. Key priorities include expanding culturally responsive speech-language services, improving access to preventive care and poststroke rehabilitation, and supporting high-risk regions like the Stroke Belt. Integrating demographic and SDOH factors into public health planning and workforce development is essential to reduce the growing burden of stroke-related aphasia and prevent deepening health disparities. https://doi.org/10.23641/asha.31141657.

This study reviewed women's health (WH) curricula at chiropractic colleges and developed core competencies for WH. Instructors of chiropractic colleges who taught WH-related course(s) were contacted to complete a survey that gathered pertinent material, including course objectives and targeted competencies. Survey results were used to develop an initial set of WH competencies. These were presented at an international conference workshop, with feedback from attendees who chose to participate. An e-Delphi panel was convened to finalize the core competencies, which required greater than 80% consensus for approval of each statement. Based on surveys from 7 institutions and 13 courses, 11 individuals at the international conference workshop recommended 62 core competencies within 10 domains, which were subsequently evaluated by 42 Delphi panelists (DP). After one round, all competencies met consensus. The study provided insight into the WH curriculum offered at participating chiropractic colleges. This resulted in a set of 10 domains and 62 core competencies to inform curricula that may be used by chiropractic training programs to enhance future chiropractors' knowledge and skills around WH across the lifespan and for post-graduate courses to ensure that proficiency may continue to advance in practice. These competencies go beyond women's reproductive health to include less considered milestones throughout the lifespan, including that gender is a social determinant of health, and the biological impact of social conditions, such as age in this population.

Social determinants of health and quality of life among Korean Americans with chronic hepatitis B.

Urban-rural disparities in menarcheal timing: a longitudinal cohort study examining social determinants of health (SDOH), screen time, and hormonal influences among adolescent girls in West Bengal, India.

Examining the underreporting of social determinants of health in randomized controlled trials published in spine journals.