Data Element


The knowledge and skills gained through education, the credentialing linked to the completion of various levels of schooling, and the quality of education. (Institute of Medicine, Capturing Social and Behavioral Domains in Electronic Health Records, Phase 2, p. 68 (2014).)


CDC's comment on behalf of NACCHO for USCDI v5

Standardized SDoH information would provide value to LHDs by reducing the time gap between when the data is collected and when it is available for LHDs to use in their programing. These data elements should follow the consensus-based terminology developed by the Gravity Project.

CDC's Consolidated Comment for USCDI v5

We provide recommendation for a core set of priority SDOH coded terminologies be required in USCDI v5. This core set is needed in order for these elements to be included in standard build for improved data capture and interoperability. These should be separate from the current four SDOH elements (of assessment, goals, interventions and problems) which represent broad categories and allow optionality of hundreds of coded terminologies. The base set of required SDOH international standard data elements (coded terminologies) will advance priority SDOH initiatives of the White House, department and agency missions, for partners and the public, and within the clinical setting. They are aligned with policy, programs, and evaluation and clinical tools for improved data assets and evidenced based decision-making benefiting patients and populations. 

Education as SDOH data element under USCDI or ISA

NACHC would like to resupport this data element for consideration / inclusion to USCDIv3.

All federally qualified health centers (FQHCs) gather SDOH data, which includes a focus on this data element through the PRAPARE screening tool. This data is relevant to and encompasses in 2019 29 million patients at 1400+ FQHCs with more than 13000 health care delivery sites. 

If this data element is not considered for addition to USCDI, we would like to comment on it's addition to ISA as a coded data element under SDOH, with applicable standards and representation accross ICD-10-CM, SNOMED-CT and LOINC.

Please see attached document supporting this. 

CDC's Consolidated Comment for USCDI v4

  1. To  Use Case Description Section please add the following text at the begining of the section ;
  • Differences in SDOH contribute to the stark and persistent disease disparities in the United States among racial, ethnic, and socioeconomic groups, systematically limiting opportunities for members of some groups to be healthy. While public health crises and economic uncertainty may focus attention on disparities, health inequities have persisted across generations because of structural policies and practices that have systematically limited health access and opportunities. It is crucial to capture data elements on risks and drivers of inequity for leading health conditions (such as Education level) as often captured in the social history for patient management and of importance for population health supports. The healthcare and public health missions and duties are supported by electronic health information (EHI) measurements around health behaviors, social determinants, equity, and outcomes. These data elements support equity and well-being benefiting individual and population level health. They address domains including SDOH drivers, risk factors and protective behaviors (e.g., physical activity as a vital sign and food as medicine), vulnerability indices, systematic race and ethnicity reporting, and medical outcomes of consequence. 
  • Healthy People 2030. Social determinants of health have a major impact on people's health and well-being — and they're a key focus of Healthy People 2030.Healthy people 2030 domains for SDOH (as well as some other domains of interest to us) include: Economic Stability; Education Access and Quality; Health Care Access and Quality; Neighborhood and Built Environment; Social and Community Context. People with higher levels of education are more likely to be healthier and live longer. Healthy People 2030 focuses on providing high-quality educational opportunities for children and adolescents — and on helping them do well in school as it impacts their health outcomes throughout life. Therefore, this data element is important for informing future public health action. It is critical to focus on achieving health equity by reducing disparities.  
  1. To Estimated number of stakeholders capturing, accessing using or exchanging section please add at the beginning:
  • The data exchange will benefit 329.5 million entire (US population number (2020)). SDOH cross-cuts all people, all practices as well as organizations, federal agencies, and partners.  It is of priority to the federal government, HHS, healthcare and public health and the people served. This data class (and the elements contained within it) are pertinent to all stakeholders that directly partner with patients toward improving patient health and stakeholders who gather, aggregate, and use data to make decisions on policy, programs, and resources toward the improved health of populations (Gravity). 
  1. Applicable Standard(s) please add ;


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