Building an Evidence Case for Capturing Educational Attainment in the EHR as a Social Determinant of Health

Educational attainment is an important social determinant of health, but it is not included in the electronic health records of a majority of adults. When the information is available, it is frequently not captured in a way that makes it easy to use in large data-only studies. This study will build evidence for the value of including educational attainment as a discrete categorical variable in electronic health records by examining the association of educational attainment with prevalence of chronic health conditions, obesity and smoking, quality metrics, and use of health care services and the patient portal among Medicaid enrollees aged 25-64 and a cohort of Medicare-aged (65-89 years) adults. The study will also examine differences by education across and within race/ethnic groups and within age groups, adjusted for sex and race/ethnicity. Lastly, we will evaluate different cut-points for educational attainment to make recommendations on ways to dichotomize education as a risk predictor.

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