Читать книгу The Science of Health Disparities Research - Группа авторов - Страница 73

EHRs are proving to be significant partners in research. The Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records with the Board on Population Health and Public Health Practice published Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 [34]. The effort conceptualizes the EHR as a kind of nervous system with the potential to unify policy and business frameworks and to produce coordinated action on improving healthcare in light of social and behavioral research. Guided by the National Academies of Science, the committee recommended expanding the four domains commonly collected (tobacco use, alcohol use, race/ethnicity, residential address) with eight more (education level, financial resource strain, stress, depression, physical activity, social isolation, intimate partner violence, and neighborhood median household income [deduced from address]).

These variables are known as “psychosocial vital signs” and are considered means to ensure that all clinical, public health, and community resources needed were made available to patients [35]. Behavioral determinants of health—physical activity joins tobacco use and alcohol use—figure prominently. This information can help link patients who need support to improve physical activity, alter alcohol habits, change diet, or access other resources in the community known to healthcare personnel.

Many of the domains are directly aligned with those in the World Health Organization PROGRESS mnemonic (place of residence [rural or urban], race/ethnicity, occupation, gender, religion, education level, socioeconomic position, and social capital or resources) [25]. Standardizing this information may facilitate better care, improve population health, and promote more informative research, but also help patients overcome barriers to prevention and wellness efforts by identifying modifiable determinants of health when support can be established.