Invited commentary: is the polysocial score approach valuable for advancing social determinants of health research?

ABSTRACT

Social determinants of health encompass the social environmental factors and lived experiences that collectively shape an individual's health. Recently, the polysocial score approach has been introduced as an innovative method for capturing the cumulative impact of a broad spectrum of social factors. This approach offers a promising opportunity to complement and enhance conventional methodologies in the advancement of research on social determinants of health. In this issue of the Journal, Jawadekar et al (Am J Epidemiol. 2024;193(9)1296­1300) evaluate the value of the polysocial score for predicting cognitive performance and mortality among middle-aged and older adults. Models built on a smaller set of social determinants, including race/ethnicity, sex, and education, performed comparably to the polysocial score models in which a more complex set of social factors was included. In this invited commentary, I evaluate the predictive ability of the polysocial score and discuss its merits and limitations. I also summarize the practical utility of the polysocial score in predicting health outcomes and its mechanistic significance in unveiling the relationship between genetics, social environment, and lifestyles in shaping an individual's health and elucidate health disparities. Lastly, I propose several avenues for future research.