Challenges exist in the study of social determinants of health (SDH) because of limited comparability of population-based U.S. data on SDH. This limitation is due to differences in disparity or equity measurements, as well as general data quality and availability. We reviewed the current SDH variables collected for HIV, viral hepatitis, sexually transmitted diseases, and tuberculosis at the Centers for Disease Control and Prevention through its population-based surveillance systems and assessed specific system attributes. Results were used to provide recommendations for a core set of SDH variables to collect that are both feasible and useful. We also conducted an environmental literature scan to determine the status of knowledge of SDH as underlying causes of disease and to inform the recommended core set of SDH variables.
References
1.
Centers for Disease Control and Prevention (US). Establishing a holistic framework to reduce inequities in HIV, viral hepatitis, STDs, and tuberculosis in the United States. Atlanta: CDC; October 2010.
2.
BravemanPGruskinS.Defining equity in health. J Epidemiol Community Health2003;57:254–8.
3.
World Health Organization, Commission on Social Determinants of Health. Closing the gap in a generation: Health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: WHO; 2008.
4.
RaphaelD.Introduction to the social determinants of health. In: RaphaelD, editor. Social determinants of health: Canadian perspectives. Toronto: Canadian Scholar's Press, Inc.;2004. p. 1–8.
5.
HaweP.The social determinants of health: How can a radical agenda be mainstreamed?Can J Public Health2009;100:291–3.
6.
TarlovAR, Public policy frameworks for improving population health. Ann N Y Acad Sci1999;896:281–93.
LaumannEOYoumY.Racial/ethnic group differences in the prevalence of sexually transmitted diseases in the United States: A network explanation. Sex Transm Dis1999;26:250–61.
BanksJMarmotMOldfieldZSmithJP, Disease and disadvantage in the United States and in England. JAMA2006;295:2037–45.
11.
WilliamsDRCollinsC.U.S. socioeconomic and racial differences in health: Patterns and explanations. Annu Rev Sociol1995;21:349–86.
12.
KriegerNChenJTEbelG.Can we monitor socioeconomic inequalities in health? A survey of U.S. health departments' data collection and reporting practices. Public Health Rep1997;112:481–91.
13.
KriegerNWilliamsDRMossNE, Measuring social class in US public health research: Concepts, methodologies, and guidelines. Annu Rev Public Health1997;18:341–78.
14.
WoodwardAKawachiI.Why reduce health inequalities?J Epidemiol Community Health2000;54:923–9.
15.
KriegerNChenJTWatermanPDRehkopfDHSubramanianSV, Race/ethnicity, gender, and monitoring socioeconomic gradients in health: A comparison of area-based socioeconomic measures—the Public Health Disparities Geocoding Project. Am J Public Health2003;93:1655–71.
16.
MacintyreSEllawayACumminsS.Place effects on health: How can we conceptualise, operationalise and measure them?Soc Sci Med2002;55:125–39.
17.
BravemanPACubbinCEgerterSChideyaSMarchiKSMetzlerM, Socioeconomic status in health research: One size does not fit all. JAMA2005;294:2879–88.
18.
KriegerNChenJTWatermanPDRehkopfDHSubramanianSV, Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: The Public Health Disparities Geocoding Project. Am J Public Health2005;95:312–23.
19.
RehkopfDHHaughtonLTChenJTWatermanPDSubramanianSVKriegerN.Monitoring socioeconomic disparities in death: Comparing individual-level education and area-based socioeconomic measures. Am J Public Health2006;96:2135–8.
20.
NisbettRE, Intelligence and how to get it: Why schools and cultures count. New York: W.W. Norton & Company, Inc.; 2009.
21.
PascoeEARichmanL. SmartPerceived discrimination and health: A meta-analytic review. Psychol Bull2009;135:531–54.
22.
MetzlerM.Social determinants of health: What, how, why, and now. Prev Chronic Dis2007;4:A85.
23.
LopezRP, Public health, the APHA, and urban renewal. Am J Public Health2009;99:1603–11.
24.
MatherMMossaadN.Children in persistently poor neighborhoods. Washington: Population Reference Bureau; 2009.
25.
OsypukTLGaleaSMcArdleNAcevedo-GarciaD.Quantifying separate and unequal: Racial-ethnic distributions of neighborhood poverty in metropolitan America. Urban Aff Rev Thousand Oaks Calif2009;45:25–65.
26.
SimmsMFortunyKHendersonE.Racial and ethnic disparities among low-income families. Low-Income Working Families (LIWF) fact sheet. Washington: Urban Institute; 2009.
27.
WoolfSH, Social policy as health policy. JAMA2009;301:1166–9.
28.
Institute of Medicine. For the public's health: The role of measurement in action and accountability. Washington: National Academies Press; 2010.
29.
SteeleCBMeléndez-MoralesLCampoluciRDeLucaNDeanHD, Health disparities in HIV/AIDS, viral hepatitis, sexually transmitted diseases, and tuberculosis in the United States: Issues, burden, and response. A retrospective review, 2000–2004. Atlanta: Centers for Disease Control and Prevention (US); 2007.
30.
AnsariZCarsonNJAcklandMJVaughanLAdrianSerraglio. A public health model of the social determinants of health. Soz Präventivmed2003;48:242–51.
FriedenTR, A framework for public health action: The health impact pyramid. Am J Public Health2010;100:590–5.
33.
CDC (US), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. 2006disease profile. Atlanta: CDC; 2008.
34.
CDC (US), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. 2007disease profile. Atlanta: CDC; 2009.
35.
CDC (US), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Strategic plan 2010–2015. Atlanta: CDC; 2010.
36.
BravemanPA, Monitoring equity in health and healthcare: A conceptual framework. J Health Popul Nutr2003;21:181–92.
37.
KindigDDayPFoxDMGibsonMKnickmanJLomasJ, What new knowledge would help policymakers better balance investments for optimal health outcomes?Health Serv Res2003;38 (6 Pt 2):1923–37.
38.
SatcherD.Ethnic disparities in health: The public's role in working for equality. PLoS Med2006;3:e405.
39.
GermanRRLeeLMHoranJMMilsteinRLPertowskiCAWallerMN, Updated guidelines for evaluating public health surveillance systems: Recommendations from the Guidelines Working Group. MMWR Recomm Rep2001;50(RR-13):1–35.
CDC (US). CDC tuberculosis surveillance data training—Report of Verified Case of Tuberculosis (RVCT) [cited 2011 May 5]. Available from: URL: http://www.cdc.gov/tb/programs/rvct/default.htm.
44.
HillemeierMLynchJHarperSCasperM.Data set directory of social determinants of health at the local level. Atlanta: CDC (US); 2004.
45.
Subpopulation estimates from the HIV incidence surveillance system—United States, 2006. MMWR Morb Mortal Wkly Rep2008;57(36):985–9.
KlevensRMFlemingPLLiJGainesCGGallagherKSchwarczS, The completeness, validity, and timeliness of AIDS surveillance data. Ann Epidemiol2001;11:443–9.
48.
Hall HI, Mokotoff ED; Advisory Group for Technical Guidance on HIV/AIDS Surveillance. Setting standards and an evaluation framework for human immunodeficiency virus/acquired immunodeficiency syndrome surveillance. J Public Health Manag Pract2007;13:519–23.
49.
JajoskyRAGrosecloseSL, Evaluation of reporting timeliness of public health surveillance systems for infectious diseases. BMC Public Health2004;4:29.
50.
DanielsDGrytdalSWasleyA.Surveillance for acute viral hepatitis—United States, 2007. MMWR Surveill Summ2009;58(3):1–27.
51.
CDC (US), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Sexually transmitted diseases surveillance2007. Atlanta: CDC; December 2008.
52.
LönnrothKJaramilloEWilliamsBGDyeCRaviglioneM.Drivers of tuberculosis epidemics: The role of risk factors and social determinants. Soc Sci Med2009;68:2240–6.
53.
LönnrothKHoltzTHCobelensFChuaJvan LethFTupasiT, Inclusion of information on risk factors, socio-economic status and health seeking in a tuberculosis prevalence survey. Int J Tuberc Lung Dis2009;13:171–6.
54.
Trends in tuberculosis—United States, 2008. MMWR Morb Mortal Wkly Rep2009;58(10):249–53.
55.
CDC (US), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Reported tuberculosis in the United States, 2008. Atlanta: CDC; September 2009.
56.
CDC (US), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Sexually transmitted disease surveillance 2007 supplement: Gonococcal Isolate Surveillance Project (GISP), annual report2007. Atlanta: CDC; March 2009.
57.
JoesoefMWeinstockHSKentCKChowJMBoudovMRParvezFM, Sex and age correlates of chlamydia prevalence in adolescents and adults entering correctional facilities, 2005: Implications for screening policy. Sex Transm Dis2009;36(2 Suppl):S67–71.
58.
AralSOFentonKAHolmesKK, Sexually transmitted diseases in the USA: Temporal trends. Sex Transm Infect2007;83:257–66.
59.
CurtisABMcCrayEMcKennaMOnoratoIM, Completeness and timeliness of tuberculosis case reporting. A multistate study. Am J Prev Med2001;20:108–12.
60.
CDC (US), Sexual and Gender Minorities Workgroup. Bylaws of the CDC Sexual and Gender Minorities Workgroup. Atlanta: CDC; 2003.
Department of Labor (US). Bureau of Labor Statistics database and tools [cited 2009 Aug 14]. Available from: URL: http://www.bls.gov/data.
64.
Department of Justice (US). Bureau of Justice statistics [cited 2009 Aug 26]. Available from: URL: http://bjs.ojp.usdoj.gov.
65.
Department of Labor (US), Bureau of Labor Statistics. Current Population Survey [cited 2009 Aug 26]. Available from: URL: http://www.bls.gov/cps.
66.
Krieger N, Waterman PD, Chen JT, Soobader MJ, Subramanian SV. Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis, and violence: Geocoding and choice of area-based socioeconomic measures—the Public Health Disparities Geocoding Project (US). Public Health Rep2003;118:240–60.
67.
Patient Protection and Affordable Care Act, Pub. L. No. 111–148, 124 Stat. 119 (2010).
68.
ZierlerSKriegerN.Reframing women's risk: Social inequalities and HIV infection. Annu Rev Public Health1997;18:401–36.
69.
FarleyTA, Sexually transmitted diseases in the southeastern United States: Location, race, and social context. Sex Transm Dis2006;33 (7 Suppl):S58–64.
70.
HammettTMDrachman-JonesA.HIV/AIDS, sexually transmitted diseases, and incarceration among women: National and southern perspectives. Sex Transm Dis2006;33(7 Suppl):S17–22.
71.
Courtenay-QuirkCPalsSLKidderDPHennyKEmshoffJG, Factors associated with incarceration history among HIV-positive persons experiencing homelessness of imminent risk of homelessness. J Community Health2008;33:434–43.
72.
SumartojoE.Structural factors in HIV prevention: Concepts, examples, and implications for research. AIDS2000;14 Suppl 1:S3–10.
73.
AdimoraAASchoenbachVJ, Contextual factors and the black-white disparity in heterosexual HIV transmission. Epidemiology2002;13:707–12.
74.
MoralesLSLaraMKingtonRSValdezROEscarceJJ, Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes. J Health Care Poor Underserved2002;13:477–503.
75.
ChenLEvansTAnandSBouffordJIBrownHChowdhuryM, Human resources for health: Overcoming the crisis. Lancet2004;364:1984–90.
76.
SinghGKSiahpushM.Widening socioeconomic inequalities in US life expectancy, 1980–2000. Int J Epidemiol2006;35:969–79.
77.
MearaERRichardsSCutlerDM, The gap gets bigger: Changes on mortality and life expectancy, by education, 1981–2000. Health Aff (Millwood)2008;27:350–60.
78.
StratfordDMizunoYWilliamsKCourtenay-QuirkCO'LearyA.Addressing poverty as risk for disease: Recommendations from CDC's consultation on microenterprise as HIV prevention. Public Health Rep2008;123:9–20.
79.
GaleaSVlahovD.Social determinants and the health of drug users: Socioeconomic status, homelessness, and incarceration. Public Health Rep2002;117 Suppl 1:S135–45.
80.
KriegerNZierlerSHoganJWWatermanPChenJLemieuxK, Geocoding and measurement of neighborhood socioeconomic position: A U.S. perspective. In: KawachiIBerkmanLF, editors. Neighborhoods and health. New York: Oxford University Press, Inc.; 2003. p. 147–65.
81.
BatesIFentonCGruberJLallooDLaraA MedinaSquireSB, Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease. Part 1: Determinants operating at individual and household level. Lancet Infect Dis2004;4:267–77.
82.
HoltgraveDRBriddellKLittleEBendixenAVHooperMKidderDP, Cost and threshold analysis of housing as an HIV prevention intervention. AIDS Behav2007;11(6 Suppl):162–6.
83.
KidderDPWolitskiRJRoyalSAidalaACourtenay-QuirkCHoltgraveDR, Access to housing as a structural intervention for homeless and unstably housed people living with HIV: Rationale, methods, and implementation of the Housing and Health Study. AIDS Behav2007;11(6 Suppl):149–61.
84.
WolitskiRJKidderDPFentonKA, HIV, homelessness, and public health: Critical issues and a call for increased action. AIDS Behav2007;11(6 Suppl):167–71.
85.
KidderDPWolitskiRJPalsSLCampsmithML, Housing status and HIV risk behaviors among homeless and housed persons with HIV. J Acquir Immune Defic Syndr2008;49:451–5.
86.
HarrisonK McDavidLingQSongRHallHI, County-level socioeconomic status and survival after HIV diagnosis, United States. Ann Epidemiol2008;18:919–27.
87.
SzczepuraA.Access to health care for ethnic minority populations. Postgrad Med J2005;81:141–7.
88.
HallHIMcDavidKLingQSloggettA.Determinants of progression to AIDS or death after HIV diagnosis, United States, 1996 to 2001. Ann Epidemiol2006;16:824–33.
89.
WohlfeilerD.Structural and environmental HIV prevention for gay and bisexual men. AIDS2000;14 Suppl 1:S52–6.
90.
ColemanCL, Determinants of HIV and AIDS among young African-American men who have sex with men: A public health perspective. J Natl Black Nurses Assoc2003;14:25–9.
91.
MuleNJRossLEDeeproseBJacksonBEDaleyATraversA, Promoting LGBT health and wellbeing through inclusive policy development. Int J Equity Health2009;8:18.
92.
FarmerPConnorsMSimmonsJ.Women, poverty and AIDS: Sex, drugs and structural violence. Monroe (ME): Common Courage Press; 1996.
93.
TurmenT.Gender and HIV/AIDS. Int J Gynaecol Obstet2003;82:411–8.
94.
QuinnTCOverbaughJ.HIV/AIDS in women: An expanding epidemic. Science2005;308:1582–3.
95.
StempleL.Health and human rights in today's fight against HIV/AIDS. AIDS2008;22 Suppl 2:S113–21.
96.
JamesCVSalganicoffAThomasMRanjiULillie-BlantonMWynR.Putting women's health care disparities on the map: Examining racial and ethnic disparities at the state level. Menlo Park (CA): Kaiser Family Foundation; 2009.
97.
KewMFrancoisGLavanchyDMargolisHVan DammePGrobP, Prevention of hepatitis C virus infection. J Viral Hepat2004;11:198–205.
98.
WardJW, Time for renewed commitment to viral hepatitis prevention. Am J Public Health2008;98:779–81.
99.
MarmotM.Social determinants of health inequalities. Lancet2005;365:1099–104.
100.
EulerGLWootenKGBaughmanALWilliamsWW, Hepatitis B surface antigen prevalence among pregnant women in urban areas: Implications for testing, reporting, and preventing perinatal transmission. Pediatrics2003;111(5 Part 2):1192–7.
101.
McQuillanGMColemanPJKruszon-MoranDMoyerLALambertSBMargolisHS, Prevalence of hepatitis B virus infection in the United States: The National Health and Nutrition Examination Surveys, 1976 through 1994. Am J Public Health1999;89:14–8.
102.
de WitJBVetRSchuttenMvan SteenbergenJ.Social-cognitive determinants of vaccination behavior against hepatitis B: An assessment among men who have sex with men. Prev Med2005;40:795–802.
103.
GishRGGadanoAC, Chronic hepatitis B: Current epidemiology in the Americas and implications for management. J Viral Hepat2006;13:787–98.
104.
KimWRBensonJTTherneauTMTorgersonHAYawnBPMeltonLJ3rd. Changing epidemiology of hepatitis B in a U.S. community. Hepatology2004;39:811–6.
105.
ParrishDDKentCK, Access to care issues for African American communities: Implications for STD disparities. Sex Transm Dis2008;35(12 Suppl):S19–22.
106.
ThomasJC, From slavery to incarceration: Social forces affecting the epidemiology of sexually transmitted diseases in the rural South. Sex Transm Dis2006;33(7 Suppl):S6–10.
107.
ChessonHWZaidiAAAralSO, Decreasing age disparities in syphilis and gonorrhea incidence rates in the United States, 1981–2005. Sex Transm Dis2008;35:393–7.
108.
HogbenMLeichliterJS, Social determinants and sexually transmitted disease disparities. Sex Transm Dis2008;35(12 Suppl):S13–8.
109.
RietmeijerCHopkinsEGeislerWMOrrDPKentCK, Chlamydia trachomatis positivity rates among men tested in selected venues in the United States: A review of the recent literature. Sex Transm Dis2008;35(11 Suppl):S8–18.
110.
DuPMcNuttLAO'CampoPColesFB, Changes in community socioeconomic status and racial distribution associated with gonorrhea rates: An analysis at the community level. Sex Transm Dis2009;36:430–8.
111.
ThomasJCClarkMRobinsonJMonnettMKilmarxPHPetermanTA, The social ecology of syphilis. Soc Sci Med1999;48:1081–94.
112.
SantelliJSLowryRBrenerNDRobinL.The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among US adolescents. Am J Public Health2000;90:1582–8.
113.
AralSO, Determinants of STD epidemics: Implications for phase appropriate intervention strategies. Sex Transm Infect2002;78 Suppl 1:i3–13.
114.
UpchurchDMMasonWMKusunokiYKriechbaumMJ, Social and behavioral determinants of self-reported STD among adolescents. Perspect Sex Reprod Health2004;36:276–87.
115.
MeadHCartwright-SmithLJonesKRamosCWoodsKSiegelB.Racial and ethnic disparities in U.S. health care: A chartbook. New York: The Commonwealth Fund; 2008.
116.
FarrSLKraftJMWarnerLAndersonJEJamiesonDJ, The integration of STD/HIV services with contraceptive services for young women in the United States. Am J Obstet Gynecol2009;201:142e1–8.
117.
MarshallBDKerrTShovellerJAMontanerJSWoodE.Structural factors associated with an increased risk of HIV and sexually transmitted infection transmission among street-involved youth. BMC Public Health2009;9:7.
118.
NewmanLMBermanSM, Epidemiology of STD disparities in African American communities. Sex Transm Dis2008;35(12 Suppl): S4–12.
119.
DavidAMMercadoSPBeckerDEdmundoKMugishaF.The prevention and control of HIV/AIDS, TB and vector-borne diseases in informal settlements: Challenges, opportunities and insights. J Urban Health2007;84(3 Suppl):i65–74.
120.
AsgharRJPatlanDEMinerMCRhodesHDSolagesAKatzDJ, Limited utility of name-based tuberculosis contact investigations among persons using illicit drugs: Results of an outbreak investigation. J Urban Health2009;86:776–80.
121.
BuffAMSosaLEHoopesAJBuxton-MorrisDCondrenTBHadlerJL, Two tuberculosis genotyping clusters, one preventable outbreak. Public Health Rep2009;124:490–4.
122.
FriedenTR, Lessons from tuberculosis control for public health. Int J Tuberc Lung Dis2009;13:421–8.
