Social Determinants of Health and the Use of Community-Based Rehabilitation Following Stroke: Methodologic Considerations

Social determinants are non-medical factors frequently used to study disparities in health outcomes1, 2 but have not been widely explored in regard to rehabilitation services utilization. In our NICHD-funded study, Access to and Effectiveness of Community-Based Rehabilitation After Stroke, we reviewed several conceptual models and frameworks for the study of social determinants to inform our work. The overall objective of this special communication is to describe our approach to identifying, selecting, and utilizing area-level measures of social determinants to explore the relationship between social determinants and rehabilitation use. We present our methods for developing a conceptual model and a methodological framework for the selection of social determinant measures relevant to rehabilitation use and an overview of publicly available data on social determinants. We then discuss methodological challenges encountered and future directions for this work.