Standardized Terminology and Social Determinants of Health

What Is Standardized Terminology?

As we’ve outlined in previous articles, a standardized terminology is simply a common language, nomenclature, classification, or taxonomy designed to be shared among users. Standardized terminology allows interoperability between technologies like electronic health records.

A good standardized terminology is research-based and meets criteria for interoperability. We’ve previously written an article outlining the criteria of a good standardized terminology.

What Are Social Determinants of Health?

The World Health Organization (WHO) defines Social Determinants of Health (SDOH) as, “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.”

Social Determinants of Health and Equity:

Why Do Social Determinants of Health Matter?

SDOH influence both the health of individuals as well as the health of whole communities. Disparities in education, access to food, the availability of work, social support, etc. create health disparities downstream.

Addressing SDOH is an upstream intervention to address health inequities.

How Do Social Determinants of Health Relate to Health Equity?

As discussed in our article, “10 Basic Things You Need to Know About Public Health 3.0,” shifting populations in the US have led to shifting demographics. These shifting demographics have meant a shift in the leading health challenges facing communities. Leading causes of death are now largely attributed to behaviors vs. disease or illness (e.g., smoking, eating patterns, etc.). Those behaviors are shaped and formed by a person’s environment, including access to healthcare, exposure to pollution, access to safe areas to walk and exercise, etc.

The California Endowment’s Building Healthy Communities Initiative created a video outlining the part a person’s zip code plays in their overall health, even going so far as to say that a person’s zip code is a greater determinant of their health than their genetics:

“Not all communities have the necessary ingredients for health. People who reside in areas without easy access to healthy food options, parks for exercise, and good schools for their children have shorter lives than those who live in more affluent communities.”

Health Equity Is Central to the 10 EPHS

One of the key changes in the 2020 revision of the 10 Essential Public Health Services was the centering of equity.

According to the Public Health National Center for Innovation (PHNCI), “The revised framework adds a new statement to elevate the importance of equity in public health practice. The concept is centered within the framework itself to highlight the overarching goal of protecting and promoting the health of all people in all communities.”

What Does This Mean for Public Health?

Documenting Social Determinants of Health Helps Achieve Health Equity

While the conceptual focus of the 10 EPHS on health equity is wonderful, even PHNCI acknowledges a frequently asked question is, “How does the revised framework change on the ground public health work?”

If we understand that upstream interventions to address health equity necessitate changing community environments, then we also understand the need to affect change at the legislative and policy level. This means that public health workers need to be able to communicate the community health needs as well as what changes will meet those needs.

Documenting SDOH is a step in compiling the kind of data that can be used to affect change.

SDOH Should Be Documented in A Meaningful Way with Standardized Terminology

Data is most effective when it is organized and meaningful. Electronic health records (EHRs) are one technological tool available to public health departments today to help document SDOH. But not all EHRs are created equal. To have organized data that can be reported on and used to prove outcomes, that data needs to be documented using a standardized terminology.

Standardized Terminology for Public Health

Meaningful Standardized Terminology

You want to ensure your EHR fully integrates the standardized terminology and employs it in a meaningful way. Many EHRs claim to be based on or integrated with a standardized terminology, but either do not employ the entire standardized terminology, or allow users to pick and choose what pieces of the standardized terminology they apply. This hamstrings the communication and reporting power of standardized terminology.

Nightingale Notes and The Omaha System as An Example

One example of an excellent standardized terminology is the Omaha System. The Omaha System was one of the first clinical nomenclatures to be developed. In our earlier article about the Omaha System standardized terminology, we note that it benefits public health workers by providing interoperability and communication across the continuum of community health.

Nightingale Notes is Champ Software’s electronic health record designed for and continually tailored to the ever-evolving needs of public health. As such, it was vitally important to Champ Software to build Nightingale Notes EHR on the Omaha System standardized terminology and implement every aspect of the Omaha System.

Every piece of data put into the software can be pulled back out in a report. This is essential for public health workers looking to document SDOH in their community. That data can be reported on in a meaningful way to prove to legislators, policy makers, grant funders, and decision makers why and how public health is affecting health equity with upstream interventions.

To read more about how standardized terminology gives public health a voice, see our article of the same name.