Measuring Select Social Determinants of Health Indicators Using the Behavioral Risk Factor Surveillance System

Introduction

Previous studies have demonstrated the effects of social, economic, and environmental conditions on individuals’ physical and mental health. The current study seeks to examine these effects using data from a large state-based surveillance system and to demonstrate the utility of this system for measuring social determinants of health (SDOH).   

Method

Data analysis was conducted using data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS).  In this year, 448,822 adults were sampled across the U.S. Items representing five SDOH domains including Socio-Economic Status (SES), Stress and Mental Health, Adverse Childhood Experiences (ACEs), Social Exclusion, and Social Support were examined and their relationship with self-reported health outcomes tested using logistic regression.  Outcomes included disability status, frequent mental distress (FMD), life satisfaction, heavy drinking, self-rated health, and diabetes status.   

Results

Lower SES was related to increases in diabetes and FMD. Increased levels of self-reported stress and mental health concerns were related to decreased self-rated health and increased heavy drinking and disability status. Experiencing ACEs and social exclusion were both related to disability status, decreased self-rated health, and increased FMD. Having social support was related to decreased disability and FMD as well as increased self-rated health, and less FMD.  All analyses were statistically significant using alpha = 0.05.     

Conclusions

These findings are consistent with previous studies showing that quality of living conditions are important determinants of health outcomes in adulthood. The findings also suggest that improving socio-economic and environmental conditions of individuals may result in improvements in health in the general population.