Kay Johnson
President, Johnson Group Consulting, Inc.

The Social Determinants of Health (SDOH) Learning Network was one of six strategic areas in the national phase of the Infant Mortality Collaborative Improvement and Innovation Network (IM CoIIN), aiming to build state capacity and test innovative strategies for shifting the impact of SDOH and ensuring equity in birth outcomes. Between 2015 and 2017, 21 states voluntarily participated in this network to identify recommended indicators to use in efforts to monitor and measure SDOH and health equity related to perinatal care and infant mortality reduction. In response, a process to identify key indicators was undertaken in 2017.

A broad scan of the literature and federal websites generated a list of 345 measures. A detailed process was used to analyze and narrow this list of possible measures.   The result was a framework with 11 domains and 28 measurement topics. Download diagram.

The proposed framework and candidate indicators were vetted with Infant Mortality CoIIN state teams and reviewed by an advisory group of state and national data experts. The final recommended indicator set includes 24 SDOH measures, eight (8) measures for monitoring unequal treatment in health care, and seven (7) primary outcome measures. Each indicator was assessed for data, proxy, and communication power. All of these indicators can be routinely and reliably measured at the state level, and most can be readily measured at the county level.

The final measurement framework and recommended indicators to use in efforts to monitor and measure SDOH and health equity related to perinatal care and infant mortality reduction (including data detail sheets with definitions and sources) will be released later this year.