Abstract

An integral part of delivering high-quality healthcare is understanding the social determinants of health (SDOH) of patients and of communities in which healthcare is provided. SDOH are defined by the World Health Organization as the conditions in which people are born, grow, live, work, and age.

SDOH, although experienced by individuals, exist at the community level. Healthcare systems that learn about the communities in which their patients live can adapt their services to meet the communities’ specific needs. This, in turn, can help patients and community members overcome obstacles to achieving and maintaining good health.

Usage

Additional information about SDOH is available on the Agency for Healthcare Research and Quality (AHRQ) SDOH website (https://www.ahrq.gov/sdoh/about.html).

AHRQ's database on Social Determinants of Health (SDOH) was created under a project funded by the Patient Centered Outcomes Research (PCOR) Trust Fund. The purpose of this project is to create easy to use, easily linkable SDOH-focused data to use in PCOR research, inform approaches to address emerging health issues, and ultimately contribute to improved health outcomes.The database was developed to make it easier to find a range of well documented, readily linkable SDOH variables across domains without having to access multiple source files, facilitating SDOH research and analysis.Variables in the files correspond to five key SDOH domains: social context (e.g., age, race/ethnicity, veteran status), economic context (e.g., income, unemployment rate), education, physical infrastructure (e.g, housing, crime, transportation), and healthcare context (e.g., health insurance). The files can be linked to other data by geography (county, ZIP Code, and census tract). The database includes data files and codebooks by year at three levels of geography, as well as a documentation file.The data contained in the SDOH database are drawn from multiple sources and variables may have differing availability, patterns of missing, and methodological considerations across sources, geographies, and years. Users should refer to the data source documentation and codebooks, as well as the original data sources, to help identify these patterns

This data package contains information on the conditions in the environment in which people are born, live, learn, work, play, worship; it also has age information that affects a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as place.

This dataset contains place-level (incorporated and census-designated places) social determinants of health (SDOH) measures from the American Community Survey 5-year data for the entire United States—50 states and the District of Columbia. Data were downloaded from data.census.gov using Census API and processed by the Centers for Disease Control and Prevention (CDC), Division of Population Health, Epidemiology and Surveillance Branch. The project was funded by the Robert Wood Johnson Foundation in conjunction with the CDC Foundation. These measures complement existing PLACES measures, including PLACES SDOH measures (e.g., health insurance, routine check-up). These data can be used together with PLACES data to identify which health and SDOH issues overlap in a community to help inform public health planning. To access spatial data, please use the ArcGIS Online service: https://cdcarcgis.maps.arcgis.com/home/item.html?id=d51009ea78b54635be95c6ec9955ec17.

This dataset contains ZCTA-level social determinants of health (SDOH) measures from the American Community Survey 5-year data for the entire United States—50 states and the District of Columbia. Data were downloaded from data.census.gov using Census API and processed by the Centers for Disease Control and Prevention (CDC), Division of Population Health, Epidemiology and Surveillance Branch. The project was funded by the Robert Wood Johnson Foundation in conjunction with the CDC Foundation. These measures complement existing PLACES measures, including PLACES SDOH measures (e.g., health insurance, routine check-up). These data can be used together with PLACES data to identify which health and SDOH issues overlap in a community to help inform public health planning. To access spatial data, please use the ArcGIS Online service: https://cdcarcgis.maps.arcgis.com/home/item.html?id=d51009ea78b54635be95c6ec9955ec17.

Brand performance data collected from AI search platforms for the query "social determinants of health data sources".

Social Determinants of Health Market Outlook

According to our latest research, the global Social Determinants of Health (SDOH) market size reached USD 7.2 billion in 2024, reflecting robust momentum driven by the integration of advanced analytics and digital health solutions across healthcare ecosystems. The market is anticipated to expand at a CAGR of 22.8% from 2025 to 2033, with the total market size expected to reach USD 59.6 billion by 2033. This accelerated growth is primarily fueled by the increasing recognition of the critical impact that social, economic, and environmental factors have on health outcomes, as well as the growing adoption of value-based care models globally. As per our latest research, the demand for holistic patient care and the need to address health disparities are the main catalysts propelling the SDOH market forward.

The surge in the Social Determinants of Health market is fundamentally driven by the global shift towards preventive healthcare and population health management. Healthcare organizations are increasingly recognizing that clinical care alone accounts for only a fraction of overall health outcomes, with social determinants such as housing, education, employment, and food security playing a pivotal role. This realization is prompting investments in SDOH data collection, analytics, and intervention programs that enable healthcare providers and payers to identify at-risk populations, design targeted interventions, and ultimately improve health equity. The proliferation of electronic health records (EHRs) and interoperable data platforms is further facilitating the integration of SDOH insights into clinical workflows, enhancing the ability to deliver personalized and effective care.

Another major growth driver for the SDOH market is the transition to value-based care and risk-based reimbursement models. Governments and private payers worldwide are incentivizing healthcare organizations to focus on outcomes rather than volume, which necessitates a comprehensive understanding of the social and environmental factors influencing patient health. As a result, there is a growing demand for advanced analytics, machine learning, and artificial intelligence solutions that can process and interpret large volumes of SDOH data. These technologies are enabling stakeholders to stratify risk, predict adverse health events, and allocate resources more efficiently, thereby reducing costs and improving quality of care. The increasing availability of real-time data from wearable devices, mobile applications, and community sources is also expanding the scope and effectiveness of SDOH initiatives.

Furthermore, regulatory mandates and policy initiatives are playing a crucial role in accelerating the adoption of SDOH solutions. In the United States, for instance, the Centers for Medicare & Medicaid Services (CMS) and other agencies have introduced guidelines and incentive programs that require healthcare organizations to screen for and address social determinants as part of routine care. Similar efforts are being observed in Europe and Asia Pacific, where governments are prioritizing health equity and social inclusion in their public health agendas. These policies are not only driving demand for SDOH data analytics and intervention platforms but are also fostering collaboration between healthcare providers, payers, community organizations, and technology vendors, thereby creating a vibrant and dynamic market landscape.

From a regional perspective, North America continues to dominate the SDOH market, accounting for the largest share in 2024, followed by Europe and Asia Pacific. The United States, in particular, is at the forefront due to its advanced healthcare infrastructure, strong regulatory support, and early adoption of health IT solutions. However, Asia Pacific is expected to witness the fastest growth over the forecast period, driven by rapid urbanization, rising healthcare expenditures, and increasing awareness of social health disparities. Europe also presents significant opportunities, especially with the implementation of digital health strategies and cross-sector collaborations aimed at addressing the root causes of health inequities. Latin America and the Middle East & Africa are gradually catching up, supported by government-led health reforms and international investments in healthcare infrastructure.

BackgroundDespite the incentives and provisions created for hospitals by the US Affordable Care Act related to value-based payment and community health needs assessments, concerns remain regarding the adequacy and distribution of hospital efforts to address SDOH. This scoping review of the peer-reviewed literature identifies the key characteristics of hospital/health system initiatives to address SDOH in the US, to gain insight into the progress and gaps.MethodsPRISMA-ScR criteria were used to inform a scoping review of the literature. The article search was guided by an integrated framework of Healthy People SDOH domains and industry recommended SDOH types for hospitals. Three academic databases were searched for eligible articles from 1 January 2018 to 30 June 2023. Database searches yielded 3,027 articles, of which 70 peer-reviewed articles met the eligibility criteria for the review.ResultsMost articles (73%) were published during or after 2020 and 37% were based in Northeast US. More initiatives were undertaken by academic health centers (34%) compared to safety-net facilities (16%). Most (79%) were research initiatives, including clinical trials (40%). Only 34% of all initiatives used the EHR to collect SDOH data. Most initiatives (73%) addressed two or more types of SDOH, e.g., food and housing. A majority (74%) were downstream initiatives to address individual health-related social needs (HRSNs). Only 9% were upstream efforts to address community-level structural SDOH, e.g., housing investments. Most initiatives (74%) involved hot spotting to target HRSNs of high-risk patients, while 26% relied on screening and referral. Most initiatives (60%) relied on internal capacity vs. community partnerships (4%). Health disparities received limited attention (11%). Challenges included implementation issues and limited evidence on the systemic impact and cost savings from interventions.ConclusionHospital/health system initiatives have predominantly taken the form of downstream initiatives to address HRSNs through hot-spotting or screening-and-referral. The emphasis on clinical trials coupled with lower use of EHR to collect SDOH data, limits transferability to safety-net facilities. Policymakers must create incentives for hospitals to invest in integrating SDOH data into EHR systems and harnessing community partnerships to address SDOH. Future research is needed on the systemic impact of hospital initiatives to address SDOH.

This archived SDOH Database (beta version) is available for reference. The most recent version of the SDOH Database replaces the beta version and is available on the main page. To ensure consistency in variable names and construction, analyses should not combine data from the beta version and the updated database.Download DataThe SDOH Data Source Documentation (PDF, 1.5 MB) file contains information for researchers about the structure and contents of the database and descriptions of each data source used to populate the database.The Variable Codebook (XLSX, 494 KB) Excel file provides descriptive statistics for each SDOH variable by year.

The first Social Drivers of Health (SDoH) dataset contains percentages of preventable hospitalizations (i.e., discharges) by Race/Ethnicity, preferred language spoken, expected payer, percent of employment, percent of home ownership, percent of park access and percent of access to basic kitchen facilities by the stated year. Preventable hospitalizations rates were created by dividing the number of patients who are 18 years and older and were admitted to a hospital for at least one of the preventable hospitalization diagnoses (see list below) by the total number of hospitalizations. List of preventable hospitalization diagnoses: diabetes with short-term complications, diabetes with long-term complications, uncontrolled diabetes without complications, diabetes with lower-extremity amputation, chronic obstructive pulmonary disease, asthma, hypertension, heart failure, angina without a cardiac procedure, dehydration, bacterial pneumonia, or urinary tract infection were counted as a preventable hospitalization. These conditions correspond with the conditions used in the Agency for Healthcare Research and Quality’s (AHRQ), Prevention Quality Indicator - Overall Composite Measure (PQI #90). The SDoH "overtime" dataset contains percentages of preventable hospitalizations (i.e., discharges) by Race/Ethnicity, preferred language spoken and expected payer overtime in the stated year range.

This dataset contains census tract-level social determinants of health (SDOH) measures from the American Community Survey 5-year data for the entire United States—50 states and the District of Columbia. Data were downloaded from data.census.gov using Census API and processed by the Centers for Disease Control and Prevention (CDC), Division of Population Health, Epidemiology and Surveillance Branch. The project was funded by the Robert Wood Johnson Foundation in conjunction with the CDC Foundation. These measures complement existing PLACES measures, including PLACES SDOH measures (e.g., health insurance, routine check-up). These data can be used together with PLACES data to identify which health and SDOH issues overlap in a community to help inform public health planning.

To access spatial data, please use the ArcGIS Online service: https://cdcarcgis.maps.arcgis.com/home/item.html?id=d51009ea78b54635be95c6ec9955ec17.

These datasets contain summarizing clusters and dimensions of place-based social determinant of health measures for the United States from AHRQ's Social Determinants of Health Database (https://www.ahrq.gov/sdoh/data-analytics/sdoh-data.html), along with the underlying SDOH data. Summary clusters and dimensions are available for both counties and Zip codes. The measures are taken from the 2019 and 2018 AHRQ SDOH datasets. Underlying SDOH measures are in the domains of social context, economic context, education, physical infrastructure, and healthcare context. The summary dimensions and cluster memberships for counties and Zip codes were generated using principal components analysis and hierarchical cluster analysis techniques to provide simple high-level representations of the SDOH context for counties and Zip codes.

The Research and Development Survey (RANDS) is a platform designed for conducting survey question evaluation and statistical research. RANDS is an ongoing series of surveys from probability-sampled commercial survey panels used for methodological research at the National Center for Health Statistics (NCHS). RANDS estimates are generated using an experimental approach that differs from the survey design approaches generally used by NCHS, including possible biases from different response patterns and sampling frames as well as increased variability from lower sample sizes. Use of the RANDS platform allows NCHS to produce more timely data than would be possible using traditional data collection methods. RANDS is not designed to replace NCHS’ higher quality, core data collections. Below are experimental estimates of reduced access to healthcare for three rounds of RANDS during COVID-19. Data collection for the three rounds of RANDS during COVID-19 occurred between June 9, 2020 and July 6, 2020, August 3, 2020 and August 20, 2020, and May 17, 2021 and June 30, 2021. Information needed to interpret these estimates can be found in the Technical Notes. RANDS during COVID-19 included questions about unmet care in the last 2 months during the coronavirus pandemic. Unmet needs for health care are often the result of cost-related barriers. The National Health Interview Survey, conducted by NCHS, is the source for high-quality data to monitor cost-related health care access problems in the United States. For example, in 2018, 7.3% of persons of all ages reported delaying medical care due to cost and 4.8% reported needing medical care but not getting it due to cost in the past year. However, cost is not the only reason someone might delay or not receive needed medical care. As a result of the coronavirus pandemic, people also may not get needed medical care due to cancelled appointments, cutbacks in transportation options, fear of going to the emergency room, or an altruistic desire to not be a burden on the health care system, among other reasons. The Household Pulse Survey (https://www.cdc.gov/nchs/covid19/pulse/reduced-access-to-care.htm), an online survey conducted in response to the COVID-19 pandemic by the Census Bureau in partnership with other federal agencies including NCHS, also reports estimates of reduced access to care during the pandemic (beginning in Phase 1, which started on April 23, 2020). The Household Pulse Survey reports the percentage of adults who delayed medical care in the last 4 weeks or who needed medical care at any time in the last 4 weeks for something other than coronavirus but did not get it because of the pandemic. The experimental estimates on this page are derived from RANDS during COVID-19 and show the percentage of U.S. adults who were unable to receive medical care (including urgent care, surgery, screening tests, ongoing treatment, regular checkups, prescriptions, dental care, vision care, and hearing care) in the last 2 months. Technical Notes: https://www.cdc.gov/nchs/covid19/rands/reduced-access-to-care.htm#limitations

The Research and Development Survey (RANDS) is a platform designed for conducting survey question evaluation and statistical research. RANDS is an ongoing series of surveys from probability-sampled commercial survey panels used for methodological research at the National Center for Health Statistics (NCHS). RANDS estimates are generated using an experimental approach that differs from the survey design approaches generally used by NCHS, including possible biases from different response patterns and sampling frames as well as increased variability from lower sample sizes. Use of the RANDS platform allows NCHS to produce more timely data than would be possible using traditional data collection methods. RANDS is not designed to replace NCHS’ higher quality, core data collections. Below are experimental estimates of telemedicine access and use for three rounds of RANDS during COVID-19. Data collection for the three rounds of RANDS during COVID-19 occurred between June 9, 2020 and July 6, 2020, August 3, 2020 and August 20, 2020, and May 17, 2021 and June 30, 2021. Information needed to interpret these estimates can be found in the Technical Notes. RANDS during COVID-19 included questions about whether providers offered telemedicine (including video and telephone appointments) in the last 2 months—both during and before the pandemic—and about the use of telemedicine in the last 2 months during the pandemic. As a result of the coronavirus pandemic, many local and state governments discouraged people from leaving their homes for nonessential reasons. Although health care is considered an essential activity, telemedicine offers an opportunity for care without the potential or perceived risks of leaving the home. The National Health Interview Survey, conducted by NCHS, added telemedicine questions to its sample adult questionnaire in July 2020. The Household Pulse Survey (https://www.cdc.gov/nchs/covid19/pulse/telemedicine-use.htm), an online survey conducted in response to the COVID-19 pandemic by the Census Bureau in partnership with other federal agencies including NCHS, also reports estimates of telemedicine use during the pandemic (beginning in Phase 3.1, which started on April 14, 2021). The Household Pulse Survey reports telemedicine use in the last 4 weeks among adults and among households with at least one child under age 18 years. The experimental estimates on this page are derived from RANDS during COVID-19 and show the percentage of U.S. adults who have a usual place of care and a provider that offered telemedicine in the past 2 months, who used telemedicine in the past 2 months, or who have a usual place of care and a provider that offered telemedicine prior to the coronavirus pandemic. Technical Notes: https://www.cdc.gov/nchs/covid19/rands/telemedicine.htm#limitations

The table county_2009 is part of the dataset Social Determinants of Health Database (SDOH), available at https://redivis.com/datasets/js6v-91cgjnnm6. It contains 3225 rows across 201 variables.

The table SDOH_ZCTA_2015 is part of the dataset Social Determinants of Health Database (SDOH), available at https://redivis.com/datasets/js6v-91cgjnnm6. It contains 33120 rows across 162 variables.

The Research and Development Survey (RANDS) is a platform designed for conducting survey question evaluation and statistical research. RANDS is an ongoing series of surveys from probability-sampled commercial survey panels used for methodological research at the National Center for Health Statistics (NCHS). RANDS estimates are generated using an experimental approach that differs from the survey design approaches generally used by NCHS, including possible biases from different response patterns and sampling frames as well as increased variability from lower sample sizes. Use of the RANDS platform allows NCHS to produce more timely data than would be possible using traditional data collection methods. RANDS is not designed to replace NCHS’ higher quality, core data collections. Below are experimental estimates of loss of work due to illness with coronavirus for three rounds of RANDS during COVID-19. Data collection for the three rounds of RANDS during COVID-19 occurred between June 9, 2020 and July 6, 2020, August 3, 2020 and August 20, 2020, and May 17, 2021 and June 30, 2021. Information needed to interpret these estimates can be found in the Technical Notes. RANDS during COVID-19 included a question about the inability to work due to being sick or having a family member sick with COVID-19. The National Health Interview Survey, conducted by NCHS, is the source for high-quality data to monitor work-loss days and work limitations in the United States. For example, in 2018, 42.7% of adults aged 18 and over missed at least 1 day of work in the previous year due to illness or injury and 9.3% of adults aged 18 to 69 were limited in their ability to work or unable to work due to physical, mental, or emotional problems. The experimental estimates on this page are derived from RANDS during COVID-19 and show the percentage of U.S. adults who did not work for pay at a job or business, at any point, in the previous week because either they or someone in their family was sick with COVID-19. Technical Notes: https://www.cdc.gov/nchs/covid19/rands/work.htm#limitations

The included dataset contains 10,000 synthetic Veteran patient records generated by Synthea. The scope of the data includes over 500 clinical concepts across 90 disease modules, as well as additional social determinants of health (SDoH) data elements that are not traditionally tracked in electronic health records. Each synthetic patient conceptually represents one Veteran in the existing US population; each Veteran has a name, sociodemographic profile, a series of documented clinical encounters and diagnoses, as well as associated cost and payer data. To learn more about Synthea, please visit the Synthea wiki at https://github.com/synthetichealth/synthea/wiki. To find a description of how this dataset is organized by data type, please visit the Synthea CSV File Data Dictionary at https://github.com/synthetichealth/synthea/wiki/CSV-File-Data-Dictionary.The included dataset contains 10,000 synthetic Veteran patient records generated by Synthea. The scope of the data includes over 500 clinical concepts across 90 disease modules, as well as additional social determinants of health (SDoH) data elements that are not traditionally tracked in electronic health records. Each synthetic patient conceptually represents one Veteran in the existing US population; each Veteran has a name, sociodemographic profile, a series of documented clinical encounters and diagnoses, as well as associated cost and payer data. To learn more about Synthea, please visit the Synthea wiki at https://github.com/synthetichealth/synthea/wiki. To find a description of how this dataset is organized by data type, please visit the Synthea CSV File Data Dictionary at https://github.com/synthetichealth/synthea/wiki/CSV-File-Data-Dictionary.

NCHS has linked various surveys with the Medicaid Analytic eXtract (MAX) files collected from the Centers for Medicare & Medicaid Services (CMS). Linkage of the NCHS survey participants with the CMS Medicaid MAX data provides the opportunity to study changes in health status, health care utilization and expenditures in low-income families with children and the elderly U.S. populations.

This dataset contains county-level social determinants of health (SDOH) measures from the American Community Survey 5-year data for the entire United States—50 states and the District of Columbia. Data were downloaded from data.census.gov using Census API and processed by the Centers for Disease Control and Prevention (CDC), Division of Population Health, Epidemiology and Surveillance Branch. The project was funded by the Robert Wood Johnson Foundation in conjunction with the CDC Foundation. These measures complement existing PLACES measures, including PLACES SDOH measures (e.g., health insurance, routine check-up). These data can be used together with PLACES data to identify which health and SDOH issues overlap in a community to help inform public health planning.

To access spatial data, please use the ArcGIS Online service: https://cdcarcgis.maps.arcgis.com/home/item.html?id=d51009ea78b54635be95c6ec9955ec17.