National Academy of Medicine Social and Behavioral Measures: Associations With Self-Reported Health.
BACKGROUND
Social and behavioral factors play important roles in physical and mental health; however, they are not routinely assessed in the healthcare system. A brief panel of measures of social and behavioral determinants of health (SBDs) were recommended in a National Academy of Medicine report for use in electronic health records. Initial testing of the panel established feasibility of use and robustness of the measures. This study evaluates their convergent and divergent validity in relation to self-reported physical and mental health and social desirability bias.


METHODS
Adults, aged ≥18 years, were recruited through Qualtrics online panel survey platform in 2015 (data analyzed in 2015-2016). Participants completed the (1) panel of SBD measures; (2) 12-Item Short Form Health Survey to assess associations with global physical and mental health; and (3) Marlowe-Crowne Social Desirability Scale short form to assess whether social desirability influenced associations between SBD measures and self-reported health.


RESULTS
The sample included 513 participants (mean age, 47.9 [SD=14.2] years; 65.5% female). Several SBD domain measures were associated with physical and mental health. Adjusting for age, poorer physical and mental health were observed among participants reporting higher levels of financial resource strain, stress, depression, physical inactivity, current tobacco use, and a positive score for intimate partner violence. These associations remained significant after adjustment for social desirability bias.


CONCLUSIONS
SBD domains were associated with global measures of physical and mental health and were not impacted by social desirability bias. The panel of SBD measures should now be tested in clinical settings.
Department of Psychiatry, University of California San Francisco, San Francisco, California; Center for Health and Community, University of California San Francisco, San Francisco, California. Electronic address: aric.prather@ucsf.edu.
Aric A
AA
Prather
Center for Health and Community, University of California San Francisco, San Francisco, California; Department of Family and Community Medicine, University of California San Francisco, San Francisco, California.
Laura M
LM
Gottlieb
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Center for Knowledge Management, Vanderbilt University Medical Center, Nashville, Tennessee.
Nunzia B
NB
Giuse
Center for Knowledge Management, Vanderbilt University Medical Center, Nashville, Tennessee.
Taneya Y
TY
Koonce
Center for Knowledge Management, Vanderbilt University Medical Center, Nashville, Tennessee.
Sheila V
SV
Kusnoor
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
William W
WW
Stead
Department of Psychiatry, University of California San Francisco, San Francisco, California; Center for Health and Community, University of California San Francisco, San Francisco, California.
Nancy E
NE
Adler
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D064890:Social Determinants of Health; D055815:Young Adult