EHR-Documented vs. Census-Derived Social Determinants for Type 2 Diabetes Outcomes

Assessing whether patient-reported social determinants documented in the EHR improve prediction of glycemic control beyond Census-linked area-level socioeconomic measures, in a UNC Health type 2 diabetes cohort.

Health systems now record patient-reported social determinants of health (SDoH) during routine care, to support more equitable clinical decisions. This project assesses whether these EHR-documented measures add information beyond what Census-linked area-level socioeconomic data already provide.

Using the UNC Health type 2 diabetes cohort, this project compares the predictive contribution of EHR-documented SDoH against Census-derived areal socioeconomic measures for two glycemic outcomes: continuous HbA1c and poor glycemic control (HbA1c 9% or above). Models are estimated across the full cohort and stratified by race and ethnicity to assess whether the relative value of each data source varies across subgroups. This work is in collaboration with Kahkoska, Pfaff, and Vitale, and a manuscript is under revision.