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The Association Between Social Determinants of Health, Risk Factors, Job Performance, and Health Care Costs in an
Wayne N Burton1, Alyssa B Schultz, Martha E Shepherd
1From the Environmental and Occupational Sciences, University of Illinois School of Public Health, Chicago, Illinois (W.N.B.); Global Health Management Research Core, Ann Arbor, Michigan (A.B.S.); Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee (M.E.S.); and Metro Nashville Public Schools, Nashville, Tennessee (D.H.).
Objective:
The aim of the study is to compare employees of a US school district based on their social determinants of health (SDoH). Methods: Employees ( N = 5006) were categorized into low-, medium-, or high-need SDoH tiers. Of them, n = 2469 also participated in a health risk appraisal in 2019. Subjects' average health care costs, health risk factors, and self-rated job performance were compared by SDoH tier and race. Results: Significant differences were observed among the SDoH comparison groups regarding age, gender, race, and marital status. SDoH was associated with health care costs, number of health risk factors, and self-rated job performance differently for Black and White employees. Conclusions: SDoH are complex and multifaceted. Black employees in the high-need SDoH group had higher average health care costs, lower self-rated job performance, and more average health risk factors than subjects in the lower need tiers.
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