The Social Determinants of Health in Place: A Future Families and Child Well-Being Study

Social Determinants of Health (SDH) are grouped into domains to explain collective impact on different outcomes. The purpose of this study is to examine if SDH items group together to create new domains.

A retrospective, cross-sectional study was conducted utilizing data from the Future Families and Child Wellbeing Study (FFCWS) N=4,898. Nine SDH items were assessed: neighborhood safety, walkability, personal importance of race/ethnicity, sexual orientation/gender identity, religiosity, spirituality, personal satisfaction, poverty level, and people's willingness to help others.

Factor structure was explored and confirmed using an exploratory factor analysis (EFA; n = 2,449) and confirmatory factor analysis (CFA; n = 2,449), respectively.

The final EFA used eight items, in which three factors/domains were identified: Spirituality, Social Place, and Personal Characteristics. Four of the items, neighborhood safety, walkability, neighbors' willingness to help (p<.00), and participant's poverty level loaded onto the Social Place domain. Social Place was found to have strong model fit using the CFA, χ2(2) = 2.504, p = 0.29, SRMR = .01, RMSEA = .01 (90% CI: .0 to .04), CFI = 0.99, TLI = .99.

Collectively, findings from this study provide evidence that can expand SDH research, identifying a four-item measure for place. (200/200).