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Agency for Healthcare Research and Quality Social Determinants of Health Database Review

By

by Radion (Rody) Svynarenko, Ph.D.

February 2025

The Agency for Healthcare Research and Quality (AHRQ) has developed a comprehensive Database on Social Determinants of Health (SDOH). The database is designed to make community-level data easy to use in analyses. It is very comprehensive, well-organized, and easy to use.

The database was compiled through an environmental scan of public SDOH data and includes county, ZIP Code, and census tract-level data from 2009 to 2020. It draws from 44 different data sources, such as the American Community Survey (ACS), American Hospital Association (AHA), Area Health Resource File (AHRF), American Foundation for AIDS Research (amfAR), and Centers for Disease Control and Prevention (CDC).

It includes over 17,000 variables across all geographic levels and years. It also includes information on geographical locations (e.g., county FIPS codes) that can be used to link with other data sources to conduct more detailed analyses.

The data in the AHRQ SDOH Database is organized into 6 domains, each of which is split into topics.

  1. The social context domain includes topics related to demographics, disability, and indices of socioeconomic disadvantage.
  2. The economic context includes measures of employment, income, and poverty.
  3. The education domain includes data on educational attainment, funding, literacy, numeracy, and school systems.
  4. Physical infrastructure includes access to exercise, crime, environment, food access, housing, industry composition, internet connectivity, migration, social services, and transportation.
  5. The healthcare context domain includes characteristics of healthcare facilities and providers, distance to providers, health behaviors, healthcare quality, health insurance status, utilization and cost, and health outcomes.
  6. Geography domain includes data on adjacent counties, land area with population density, and  rural-urban classification codes.

The database has one of the best codebooks available; it is very informative and intuitive to follow. It provides in-depth information on each variable, which can be filtered by year, domain, topic, and data source.

While the SDOH Database is a valuable resource, there are a few minor issues: The database ends in 2020, and it is not clear whether it will be updated in the future. Links in the codebook have not been updated since 2022. Although the variables are clearly labeled following a clear convention that includes details on the data source, this results in long variable names that are sometimes difficult to process in statistical packages like STATA and SAS. There are also several issues with the county names: FIPS code 27111 in MN was improperly labeled as “Todd County” instead of “Otter Tail County,” and FIPS code 27165, also in MN, was improperly labeled as “Washington County” instead of “Watonwan County.”

Despite these minor issues, the AHRQ’s SDOH Database is an invaluable tool for anyone working with social determinants of health data.