The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health

doi:10.1016/j.amepre.2023.03.003

. 2023 Sep;65(3):534-542.

doi: 10.1016/j.amepre.2023.03.003. Epub 2023 Mar 17.

The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health

Michelle C Krzyzanowski¹, Cataia L Ives¹, Nancy L Jones², Barbara Entwisle³, Alicia Fernandez⁴, Theresa A Cullen⁵, William A Darity Jr⁶, Mark Fossett⁷, Patrick L Remington⁸, Maile Taualii⁹, Consuelo H Wilkins¹⁰, Eliseo J Pérez-Stable¹¹, Nishadi Rajapakse¹², Nancy Breen¹¹, Xinzhi Zhang¹², Deborah R Maiese¹³, Tabitha P Hendershot¹, Meisha Mandal¹, Stephen Y Hwang¹, Wayne Huggins¹, Lauren Gridley¹, Amanda Riley¹, Erin M Ramos¹⁴, Carol M Hamilton¹

Affiliations

¹ GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina.
² National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland. Electronic address: jonesna@nimhd.nih.gov.
³ Department of Sociology, College of Arts and Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
⁴ Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, Carolina.
⁵ Regenstrief, Indianapolis, Indiana.
⁶ Sanford School of Public Policy, Duke University, Durham, North Carolina.
⁷ Department of Sociology, College of Arts & Sciences, Texas A&M University, College Station, Texas.
⁸ Department of Population Health Sciences, University of Wisconsin-Madison College of Medicine and Public Health, Madison, Wisconsin.
⁹ Center for Integrated Health Care Research, Hawaii Permanente Medical Group, Honolulu, Hawaii.
¹⁰ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
¹¹ National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland.
¹² Center for Translation Research & Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland.
¹³ Division for Research Services, RTI International, Research Triangle Park, North Carolina.
¹⁴ National Human Genome Research Institute, NIH, Bethesda, Maryland.

PMID: 36935055
PMCID: PMC10505248 (available on 2024-09-01)
DOI: 10.1016/j.amepre.2023.03.003

The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health

Michelle C Krzyzanowski et al. Am J Prev Med. 2023 Sep.

. 2023 Sep;65(3):534-542.

doi: 10.1016/j.amepre.2023.03.003. Epub 2023 Mar 17.

Authors

Affiliations

¹ GenOmics, Bioinformatics, and Translation Research Center, RTI International, Research Triangle Park, North Carolina.
² National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland. Electronic address: jonesna@nimhd.nih.gov.
³ Department of Sociology, College of Arts and Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
⁴ Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, Carolina.
⁵ Regenstrief, Indianapolis, Indiana.
⁶ Sanford School of Public Policy, Duke University, Durham, North Carolina.
⁷ Department of Sociology, College of Arts & Sciences, Texas A&M University, College Station, Texas.
⁸ Department of Population Health Sciences, University of Wisconsin-Madison College of Medicine and Public Health, Madison, Wisconsin.
⁹ Center for Integrated Health Care Research, Hawaii Permanente Medical Group, Honolulu, Hawaii.
¹⁰ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
¹¹ National Institute on Minority Health and Health Disparities, NIH, Bethesda, Maryland.
¹² Center for Translation Research & Implementation Science, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland.
¹³ Division for Research Services, RTI International, Research Triangle Park, North Carolina.
¹⁴ National Human Genome Research Institute, NIH, Bethesda, Maryland.

PMID: 36935055
PMCID: PMC10505248 (available on 2024-09-01)
DOI: 10.1016/j.amepre.2023.03.003

Abstract

Introduction: Social determinants are structures and conditions in the biological, physical, built, and social environments that affect health, social and physical functioning, health risk, quality of life, and health outcomes. The adoption of recommended, standard measurement protocols for social determinants of health will advance the science of minority health and health disparities research and provide standard social determinants of health protocols for inclusion in all studies with human participants.

Methods: A PhenX (consensus measures for Phenotypes and eXposures) Working Group of social determinants of health experts was convened from October 2018 to May 2020 and followed a well-established consensus process to identify and recommend social determinants of health measurement protocols. The PhenX Toolkit contains data collection protocols suitable for inclusion in a wide range of research studies. The recommended social determinants of health protocols were shared with the broader scientific community to invite review and feedback before being added to the Toolkit.

Results: Nineteen social determinants of health protocols were released in the PhenX Toolkit (https://www.phenxtoolkit.org) in May 2020 to provide measures at the individual and structural levels for built and natural environments, structural racism, economic resources, employment status, occupational health and safety, education, environmental exposures, food environment, health and health care, and sociocultural community context.

Conclusions: Promoting the adoption of well-established social determinants of health protocols can enable consistent data collection and facilitate comparing and combining studies, with the potential to increase their scientific impact.

Published by Elsevier Inc.

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Conflict of interest statement

The authors have no conflict of interest to declare.

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References

1. World Health Organization. Social determinants of health. Geneva, Switzerland: World Health Organization. https://www.who.int/social_determinants/thecommission/finalreport/key_co.... Published May 7, 2013. Accessed October 17, 2019.
1. Webb Hooper M, Marshall V, Pérez-Stable EJ. COVID-19 health disparities and adverse social determinants of health. Behav Med. 2022;48(2):133–140. doi:10.1080/08964289.2021.1990007 - DOI - PubMed
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1. National Institute on Minority Health and Health Disparities. NIMHD science visioning research strategies. Bethesda, MD: National Institute on Minority Health and Health Disparities. https://nimhd.nih.gov/docs/30_strategies_rationale.pdf. Published 2019. Accessed March 31, 2021.
1. Perez-Stable EJ, Collins FS. Science visioning in minority health and health disparities. Am J Public Health. 2019;109(S1):S5. doi:10.2105/AJPH.2019.304962 - DOI - PMC - PubMed

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[1] World Health Organization. Social determinants of health. Geneva, Switzerland: World Health Organization. https://www.who.int/social_determinants/thecommission/finalreport/key_co.... Published May 7, 2013. Accessed October 17, 2019.

[2] World Health Organization. Social determinants of health. Geneva, Switzerland: World Health Organization. https://www.who.int/social_determinants/thecommission/finalreport/key_co.... Published May 7, 2013. Accessed October 17, 2019.

[3] Webb Hooper M, Marshall V, Pérez-Stable EJ. COVID-19 health disparities and adverse social determinants of health. Behav Med. 2022;48(2):133–140. doi:10.1080/08964289.2021.1990007 - DOI - PubMed

[4] Webb Hooper M, Marshall V, Pérez-Stable EJ. COVID-19 health disparities and adverse social determinants of health. Behav Med. 2022;48(2):133–140. doi:10.1080/08964289.2021.1990007 - DOI - PubMed

[5] National Institute on Minority Health and Health Disparities. NIMHD research framework. Bethesda, MD: National Institute on Minority Health and Health Disparities. https://www.nimhd.nih.gov/about/overview/research-framework.html. Published 2017. Accessed January 7, 2021.

[6] National Institute on Minority Health and Health Disparities. NIMHD research framework. Bethesda, MD: National Institute on Minority Health and Health Disparities. https://www.nimhd.nih.gov/about/overview/research-framework.html. Published 2017. Accessed January 7, 2021.

[7] National Institute on Minority Health and Health Disparities. NIMHD science visioning research strategies. Bethesda, MD: National Institute on Minority Health and Health Disparities. https://nimhd.nih.gov/docs/30_strategies_rationale.pdf. Published 2019. Accessed March 31, 2021.

[8] National Institute on Minority Health and Health Disparities. NIMHD science visioning research strategies. Bethesda, MD: National Institute on Minority Health and Health Disparities. https://nimhd.nih.gov/docs/30_strategies_rationale.pdf. Published 2019. Accessed March 31, 2021.

[9] Perez-Stable EJ, Collins FS. Science visioning in minority health and health disparities. Am J Public Health. 2019;109(S1):S5. doi:10.2105/AJPH.2019.304962 - DOI - PMC - PubMed

[10] Perez-Stable EJ, Collins FS. Science visioning in minority health and health disparities. Am J Public Health. 2019;109(S1):S5. doi:10.2105/AJPH.2019.304962 - DOI - PMC - PubMed

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The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health

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The PhenX Toolkit: Measurement Protocols for Assessment of Social Determinants of Health

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