An Investigation of the Representation of Social Determinants of Health in the UMLS
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Updated: Jul 31, 2025

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Published on: September 20, 2024
Bhanu Pratap Singh Rawat1, Heather Keating2,3, Raelene Goodwin2,3
1College of Information and Computer Science, University of Massachusetts-Amherst.
Abstract:
Social Determinants of Health (SDOH) are the conditions in which people are born, live, work, and age1. Unified Medical Language System (UMLS) incorporates SDOH concepts2; but few have evaluated its coverage and quality. With 15,649 expert-annotated SDOH mentions from 3176 randomly selected electronic health record (EHR) notes, we found that 100% SDOH mentions can be mapped to at least one UMLS concept, indicating a good coverage of SDOH. However, we discovered a few challenges for the UMLS's representation of SDOH. Next, we developed a multi-step framework to identify SDOH concepts from UMLS, and a clinical BERT-based classification algorithm to assign each identified SDOH concept to one of the six general categories. Our multi-step framework extracted a total of 198, 677 SDOH concepts from the UMLS and the SDOH category classification system attained an accuracy of 91%. We also built EASE: an open-source tool to Extract SDOH from EHRs.
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