Evaluation Measures for SDOH Programs

Rural programs addressing the social determinants of health (SDOH) use a range of evaluation measures to track progress and assess outcomes and effects. Many programs addressing SDOH seek to achieve long-term outcomes related to complex social factors, such as poverty and education. For these programs, it may take years before there are measurable changes in the proportion of program participants who live in poverty or who increase their educational attainment. Therefore, it is important to also identify and assess short-term and intermediate outcome measures and process measures. Additional information on strategies and measures for data collection can be found in the Rural Community Health Toolkit.

Evaluation Measure Sources

Common sources for evaluation measures for programs addressing SDOH include:

Agency for Healthcare Research and Quality (AHRQ) Datasets – provides an extensive list of data resources that can be used to identify measures related to health, SDOH, and healthcare.
Healthy People 2030 – provides measurable objectives for five domains of SDOH, including baseline data and target rates for improvement.
PLACES Non-Medical Factors – this data webpage from the Centers for Disease Control and Prevention (CDC) provides measures and sources of data containing SDOH measures. Examples of evaluation measures include age, household broadband internet, housing cost, education, and unemployment.

Evaluation Measures by Domain

Rural programs can use many different measures when evaluating SDOH programs. Examples of evaluation measures are grouped by domain — economic stability, education, social and community context, healthcare access, and neighborhoods and the built environment.

Economic Stability. Rural SDOH programs addressing economic stability may be interested in measures related to poverty, financial assets, and unemployment. Examples of measures include:

Rate of children living in poverty
Degree of income inequality within the community or population
Rate of severe housing cost burden
Rate of homeownership
Rate of children eligible for free or reduced-price lunch
Rate of unemployment
Rate of job growth

Education. Programs addressing education in SDOH programs may use measures related to educational attainment, such as:

Proportion of eligible children enrolled in early childhood education
Rate of high school graduation
Proportion of new high school graduates enrolled in post-secondary education

Social and Community Context. When addressing the social and community context to address SDOH, programs may be interested in measures of disenfranchisement, civic engagement, incarceration, and violence. Examples include:

Percent of registered voters who voted in the last election
Rate of recidivism
Rate of incarceration

Healthcare Access. Examples of measures for SDOH programs focusing on healthcare access include:

Percent of patients enrolled in social services for which they are eligible, including Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP), or Women, Infants, and Children (WIC)
Percent of patients who are uninsured or underinsured
Rate of no-shows to healthcare appointments
Number of patient travel miles saved

Neighborhoods and the Built Environment. SDOH programs focused on making improvements to the physical environment may use measures related to pollution, environmental hazards, and land use, among many others. Examples include:

Number of drinking water violations
Number of reports of housing issues, such as mold or structural violations
Rate of children with elevated levels of lead in their blood
Number of days with high levels of air pollution particulate matter
Number of community members without a mode of transportation to work

Sample Evaluation Measures Across Domains

Rural SDOH programs may collect data about program activities that cut across disciplines or apply to multiple topics. For example, some communities may evaluate changes in policies, community participation, or community engagement. Examples of applicable measures include:

Number of stakeholders engaged in SDOH issues
Change in public awareness or action related to SDOH
Number of policies developed and enacted to address SDOH
Number of organizational changes developed and enacted to address SDOH
Amount of funding dedicated to SDOH