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The National Institutes of Health’s (NIH) National Heart, Lung, and Blood Institute (NHLBI) hosted a virtual workshop on September 29–30, 2020, to explore digital technology to create novel data sources and leverage that technology for research on social determinants of health (SDOH). Healthy People 2030 defines SDOH as “…the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Workshop participants also examined unintended consequences from technology use and discussed implementation strategies to put the new technologies into action. The workshop represented a continuation of NHLBI’s long-standing work to understand and address the drivers of racial and geographic disparities related to heart, lung, blood, and sleep (HLBS) disorders. Per the 21st Century Cures Act of 2016, both the Precision Medicine Initiative and the NIH-Wide Strategic Plan incorporate consideration of the influence of SDOH as well as biological factors on health that contribute to health disparities. Investigating the factors that account for differences in health among populations and leveraging emerging opportunities in data science are part of the NHLBI’s Strategic Vision.
Health encompasses many facets of our lives and is more than physical well-being. The disproportionate burden of coronavirus 2019 (COVID-19) on minority communities has brought U.S. health disparities—and the imperative to promote health equity—into sharp focus. Data science and novel data sources and technologies such as machine learning and mobile apps that can provide insight into SDOH and potential evidence-based approaches to eliminating health inequities.
Evidence indicates that communities and neighborhoods (e.g., ZIP Codes) drive health outcomes such as life expectancy and quality of life. A range of new digital tools and data sources present an opportunity to improve health outcomes by facilitating measurement (e.g., sensor sampling in real time), diagnosis (e.g., portable imaging), treatment (e.g., remote care), and global responses (e.g., disaster responses and disease surveillance). Challenges to realizing the enormous potential of novel technologies and data sources for improving individual and population health include those related to the digital divide—that is, inequities (particularly socioeconomic) in access to these technologies. Workshop presenters discussed solutions and presented examples of projects that overcome such challenges; overarching themes included the importance of community engagement and partnerships and the crucial need to work seamlessly across multiple sectors. A key element of community engagement is that it provides insight into how SDOH impacts health, which in turn drives health outcomes where people live, work, and play.
The following overarching themes emerged from the discussion:
Participants identified the following key considerations to address SDOH and COVID-19:
Workshop participants identified the following challenges:
Customize intervention:
Make SDOH data in electronic health records (EHRs) actionable:
Workshop Chair
Garth Graham, M.D., M.P.H., Vice President, Chief Community Health Officer, CVS Health
Workshop Leaders
Erin Iturriaga, DNP, M.S.N. NHLBI, Division of Cardiovascular Sciences (DCVS)
Rebecca Campo, Ph.D. (DCVS)
Alison Brown, M.S., Ph.D. (DCVS)
Marishka Brown, Ph.D. NHLBI, National Center on Sleep Disorders Research (NCSDR)
Patrice Desvigne-Nickens, M.D. (DCVS)
Michelle Freemer, M.D., M.P.H. NHLBI, Division of Lung Diseases
Melissa Green Parker, Ph.D., NHLBI, Center for Translation Research and Implementation Science (CTRIS)
Michelle Olive, Ph.D. (DCVS)
Nicole Redmond, M.D., Ph.D., M.P.H. (DCVS)
Sharon Smith, Ph.D. NHLBI, Division of Blood Diseases and Resources
Catherine (Kate) Stoney, Ph.D. (CTRIS)
Workshop Speakers/Moderators in Order Listed in Workshop Agenda
Gary H. Gibbons, M.D., Director, NHLBI
Mark Savage, J.D., Center for Digital Health Innovation at UCSF
Abhinav Sharma, M.D., Ph.D., McGill University Health Centre
Marie Lynn Miranda, Ph.D., Charles and Jill Fischer Provost of the University of Notre Dame
Peter James, Sc.D., Harvard Medical School Environment Exposures
Lorna E. Thorpe, Ph.D., M.P.H., NYU School of Medicine
Sarah DeSilvey, DNP, APRN-C, Northwestern Medical Center/Pediatric Faculty, Larner College of Medicine at the University of Vermont
Paula Gardiner, M.D., University of Massachusetts
Meagan Khau, M.H.A., Office of Minority Health, Center for Medicare & Medicaid Services, Director, Data and Policy Analytics Group
Jennifer Covich Bordenick, M.H.R.M., Executive Director, eHealth Initiative and Foundation (eHI)
Santosh Kumar, Ph.D., University of Memphis
Wendy Nilsen, Ph.D., National Science Foundation
David R. Wilson, Ph.D., Director, Tribal Health Research Office/NIH
Matthew Quinn, M.B.A., Science Director for the U.S. Army’s Telehealth & Advanced Technology Research Center
Stacy Lindau, M.D., M.A.P.P., NowPow’s founder and Chief Innovation Officer, Professor, University of Chicago
Taylor Justice, M.B.A., Co-Founder and President of Unite Us
Jennifer DeVoe, M.D., Oregon Health & Science University
Charles R. Jonassaint, Ph.D., M.H.S., University of Pittsburgh
Andrew Hamilton, M.S., Chief Informatics Officer and Deputy Director, AllianceChicago
For More Information
Contact Erin Iturriaga at erin.iturriaga@nih.gov or Rebecca Campo at rebecca.campo@nih.gov.