Social Determinants of Health

Are you looking to accurately measure social determinants of health?

The CAT-MH® SDoH module is an adaptive assessment of an individual’s satisfaction with social and physical environmental factors that are known to have an impact on health outcomes. This measure was designed and validated for people with mental health disorders and medical professionals may find the tool useful to better understand the systemic elements contributing to both an individual’s challenges as well as their strengths and resources. With this information, there is an opportunity to provide targeted interventions that are responsive to the broader challenges that individuals are facing.

The CAT-SDoH measures life satisfaction across seven subdomains: Family, Finances, Health, Leisure, Living, Safety, and Social. The full item bank is comprised of 35 questions with approximately 4-6 questions from each subdomain. The average number of questions adaptively administered is 9. Despite its brevity, the adaptive administration method maintains a correlation of r=0.95 with results of individuals answering all 35 questions. Results of the CAT-SDoH are reported on a 100-point scale with an estimated 5-points of precision and these scores can be compared to or integrated with traditional SDoH measures to more fully understand an individual’s SDoH. Additionally, the CAT-SDoH can be used as a general measure of life satisfaction, where changes in the score over time represent changes in life quality.


The SVM App

The Social Vulnerability Metric (SVM) is an ecological measure of social determinants of health (SDoH) jointly developed by researchers at the University of Chicago and Johns Hopkins University. The SVM App, accessed below, allows visitors to explore nationwide data and consider ways that this data can be applied and leveraged in a wide variety of settings. The breakthrough developments of the CAT-SDoH and SVM open the door to a new approach to the measurement of SDoH. For the first time, technology exists to adaptively measure SDoH from both ecological and personal perspective, when using the two together; with information as simple as an individual’s zip code, it is possible to better understand the metrics which make the individual the most vulnerable.

In the future, the SVM items and CAT-SDoH items will be jointly calibrated in the bi-factor model, used in the development of other CAT-MH® measures, and harmonized into a single metric. When using the participant’s zip code, the SVM score will “jump-start” the CAT-SDoH and provide a final SV score that reflects a synthesis of both the ecological and personal perspective, leading to a more holistic understand of an individual’s social determinants of health.

What is social vulnerability?

According to the US Department of Health and Human Services, social vulnerability refers to the potential negative effects on communities caused by external stresses on human health.

What is the social vulnerability metric?

The SVM is a model-based composite measure of over 200 SDoH indicators derived from the 2018 AHRQ SDoH Database. Variables related to social (e.g. age, race/ethnicity, veteran status), economic (e.g. income, unemployment rate), education, built environment (e.g. housing, crime, transportation), and healthcare contexts were included in the SVM. The SVM was validated using 2018 data from the CDC’s PLACES database that contains ZIP-code level data for 27 measures of chronic disease status across the entire United States.

What is the difference between the SVM and the CDC’s SVI?

The CDC’s Social Vulnerability Index (SVI) is a county-level measure ranking each county on 15 different social factors. In contrast, the Social Vulnerability Metric uses model based measurement (multidimensional item response theory) to synthesize the information in over 200 SDoH indicators into a primary dimensional vulnerability score, absorbing correlation induced by the nesting of SDoH indicators within social, economic, education, built environment, and healthcare subdomains. As a consequence, SVM accounts for 46% of the variability in all-cause age-adjusted mortality, whereas the SVI only accounts for 12%. Similar to the SVI, the SVM can be expressed as a percentile ranking; however, the SVM can be estimated at the zip-code, county, or municipal sampling unit area (MSA)

What can this app be used for?

This app offers visitors the ability to view a static national zip-code level visual of social vulnerability based on the SVM. Visitors may also interact with a county-level US and state–specific heat maps to study geographic variability in social vulnerability. Furthermore, visitors can also study the relationship between SVM scores and 24 health indicators at the zip-code level across the entire US, or within individual states. Finally, visitors may view or download the county-level or zip-code level SVM scores, and percentiles utilized in the app. We only ask that you reference the following citation in your published work:

Saulsberry L, Bhargava A, Zeng S, Gibbons JB, Brannan C, Lauderdale S, and Gibbons RD. The Social Vulnerability Metric (SVM) As A New Tool for Public Health Policy and Practice. Health Services Research, 2022;1‐9. doi:10.1111/1475- 6773.14102

Access the SVM App

By completing this form, you agree to reference the following citation in any published work. Visitors may view or download the county-level or zip-code level SVM scores, and percentiles utilized in the app. This page will redirect after the form is submitted.

Saulsberry L, Bhargava A, Zeng S, Gibbons JB, Brannan C, Lauderdale S, and Gibbons RD. The Social Vulnerability Metric (SVM) As A New Tool for Public Health Policy and Practice. Health Services Research, 2022;1‐9. doi:10.1111/1475- 6773.14102