title: Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care.
abstract: Detailed data on social determinants of health can facilitate the identification of inequities in access to health care. We report on a sociodemographic data collection tool used in a family medicine clinic.
  
  
  
  Four major health organizations in Toronto collaborated to identify a set of 14 questions that covered a range of social determinants of health. These were translated into 13 languages. This survey was self-administered using an electronic tablet to a convenience sample of 407 patients in the waiting room of a primary care clinic. Data were uploaded directly to the electronic medical record.
  
  
  
  The rate of valid responses provided for each question was high, ranging from 84% to 100%. The questions with the highest number of patients selecting "do not know" and "prefer not to answer" pertained to disabilities and income. Patients reported finding the process acceptable. In subsequent implementation across 5 clinics, 10,536 patients have been surveyed; only 724 (6.9%) declined to participate.
  
  
  
  Collecting data on social determinants of health through a self-administered survey, and linking them to a patient's chart, is feasible and acceptable. A modified survey is now administered to all patients. Such data are already being used to identify health inequities, develop novel interventions, and evaluate their impact on health outcomes.
authors.affiliation: From the Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada (ADP, RHG); the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (ADP, RHG); the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (GG-Y); Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada (AM); and the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (RHG). andrew.pinto@utoronto.ca.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Pinto
authors.affiliation: From the Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada (ADP, RHG); the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (ADP, RHG); the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (GG-Y); Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada (AM); and the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (RHG).
authors.forename: Gabriela
authors.initials: G
authors.lastname: Glattstein-Young
authors.affiliation: From the Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada (ADP, RHG); the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (ADP, RHG); the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (GG-Y); Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada (AM); and the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (RHG).
authors.forename: Anthony
authors.initials: A
authors.lastname: Mohamed
authors.affiliation: From the Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada (ADP, RHG); the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (ADP, RHG); the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (GG-Y); Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada (AM); and the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (RHG).
authors.forename: Gary
authors.initials: G
authors.lastname: Bloch
authors.affiliation: From the Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada (ADP, RHG); the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (ADP, RHG); the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (GG-Y); Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada (AM); and the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (RHG).
authors.forename: Fok-Han
authors.initials: FH
authors.lastname: Leung
authors.affiliation: From the Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ADP, GB, F-HL, RHG); the Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada (ADP, RHG); the Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada (ADP, RHG); the Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (GG-Y); Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada (AM); and the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (RHG).
authors.forename: Richard H
authors.initials: RH
authors.lastname: Glazier
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D003625:Data Collection; D003710:Demography / Q000706:statistics & numerical data; D057286:Electronic Health Records; D005194:Family Practice / Q000458:organization & administration*; D005240:Feasibility Studies; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D009864:Ontario; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D064890:Social Determinants of Health / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D057188:Workflow
keywords: Epidemiology; Health Care Disparities; Social Determinants of Health; Social Problems