Measuring social determinants of health in the All of Us Research Program.

To accelerate medical breakthroughs, the All of Us Research Program aims to collect data from over one million participants. This report outlines processes used to construct the All of Us Social Determinants of Health (SDOH) survey and presents the psychometric characteristics of SDOH survey measures in All of Us. A consensus process was used to select SDOH measures, prioritizing concepts validated in diverse populations and other national cohort surveys. Survey item non-response was calculated, and Cronbach's alpha was used to analyze psychometric properties of scales. Multivariable logistic regression models were used to examine associations between demographic categories and item non-response. Twenty-nine percent (N = 117,783) of eligible All of Us participants submitted SDOH survey data for these analyses. Most scales had less than 5% incalculable scores due to item non-response. Patterns of item non-response were seen by racial identity, educational attainment, income level, survey language, and age. Internal consistency reliability was greater than 0.80 for almost all scales and most demographic groups. The SDOH survey demonstrated good to excellent reliability across several measures and within multiple populations underrepresented in biomedical research. Bias due to survey non-response and item non-response will be monitored and addressed as the survey is fielded more completely.

Assessment of smokeless tobacco use in the history and physical examination by primary healthcare providers.

PURPOSE: Following a simple descriptive research design, we examined how and to what extent primary healthcare providers in rural southern regions of the United States ask patients about the use of smokeless tobacco as indicated in the document used for the patient history. DATA SOURCES: Copies of blank history and physical forms used in offices of primary care providers in Alabama, Georgia, South Carolina, and Tennessee were examined to identify items related specifically to tobacco use. CONCLUSIONS: Twenty-nine providers returned history and physical forms, which revealed 24% showed no item related to tobacco use. Others included questions related to smoking, but only 7% mentioned any sort of smokeless tobacco use. IMPLICATIONS FOR PRACTICE: Although a few studies have suggested the use of smokeless tobacco to be less harmful than smoking, all forms of smokeless tobacco are recognized carcinogens and dangerous for health. It is not sufficient to simply ask patients about smoking behaviors. Primary care providers, especially nurse practitioners, have the unique opportunity to assess use of smokeless tobacco and to offer treatment and counsel to help patients to stop the behavior.

Dietary linoleic and oleic fatty acids in relation to severe depressed mood: 10 years follow-up of a national cohort.

The influence of dietary fatty acids (FAs) other than omega-3 FAs on mood has been largely overlooked. The authors prospectively assessed the association between dietary linoleic and oleic FAs and the risk of severe depressed mood (SDM) among 4856 adults aged 25-74 years who were examined in 1971-1975 as a part of a national survey. Intakes of FAs were obtained at baseline from a 24-hour recall and categorized into thirds. SDM was defined as Center for Epidemiologic Studies Depression Scale scores at follow-up survey >or=22 or taking anti-depression medication. After an average of 10.6 years of follow-up, the proportion of individuals with SDM were 11.45 (SE=0.96) % and 17.45(1.05) % respectively among 1947 men and 2909 women. The odds ratios (ORs) were 1 (reference), 1.64(95% CI=1.06, 2.54) and 2.34 (1.41, 3.87) respectively for men with lowest, middle and highest third of linoleic FA intake (p for trend=0.001); the ORs were 1 (reference), 0.88 (0.56, 1.38) and 0.48 (0.25, 0.95) respectively for women with lowest, middle and highest third of oleic FA intake (p for trend=0.0347). No association was observed from saturated FA. These estimates were adjusted for fish consumption at baseline and major physical diseases at follow-up. The authors concluded that increased intake of oleic FA was associated with reduced risk among women while increased intake of linoleic FA was associated with increased risk of SDM among men.