{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T02:47:05Z","timestamp":1777430825880,"version":"3.51.4"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, \u201ccommunity vital signs\u201d (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration.<\/jats:p>","DOI":"10.1093\/jamia\/ocv088","type":"journal-article","created":{"date-parts":[[2015,7,15]],"date-time":"2015-07-15T00:19:56Z","timestamp":1436919596000},"page":"407-412","source":"Crossref","is-referenced-by-count":153,"title":["\u201cCommunity vital signs\u201d : incorporating geocoded social determinants into electronic records to promote patient and population health"],"prefix":"10.1093","volume":"23","author":[{"given":"Andrew W","family":"Bazemore","sequence":"first","affiliation":[{"name":"Robert Graham Center for Policy Studies in Primary Care, Washington, DC, USA"}]},{"given":"Erika K","family":"Cottrell","sequence":"additional","affiliation":[{"name":"OCHIN, Inc., Portland, OR, USA"},{"name":"Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA"}]},{"given":"Rachel","family":"Gold","sequence":"additional","affiliation":[{"name":"OCHIN, Inc., Portland, OR, USA"},{"name":"Kaiser Permanente NW, Center for Health Research, Portland, OR, USA"}]},{"given":"Lauren S","family":"Hughes","sequence":"additional","affiliation":[{"name":"Robert Wood Johnson Foundation Clinical Scholars Program\u00ae, Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA"}]},{"given":"Robert L","family":"Phillips","sequence":"additional","affiliation":[{"name":"American Board of Family Medicine, Washington, DC, USA"}]},{"given":"Heather","family":"Angier","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA"}]},{"given":"Timothy E","family":"Burdick","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA"},{"name":"Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA"}]},{"given":"Mark A","family":"Carrozza","sequence":"additional","affiliation":[{"name":"HealthLandscape, American Academy of Family Physicians, Cincinnati, OH, USA"}]},{"given":"Jennifer E","family":"DeVoe","sequence":"additional","affiliation":[{"name":"OCHIN, Inc., Portland, OR, USA"},{"name":"Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA"}]}],"member":"286","published-online":{"date-parts":[[2015,7,13]]},"reference":[{"issue":"7601","key":"2020110613033896700_ocv088-B1","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1136\/bmj.39167.439792.55","article-title":"Social inequalities in self reported health in early old age: follow-up of prospective cohort study","volume":"334","author":"Chandola","year":"2007","journal-title":"BMJ."},{"key":"2020110613033896700_ocv088-B2","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1186\/1471-2458-13-1170","article-title":"The social gradient in work and health: a cross-sectional study exploring the relationship between working conditions and health inequalities","volume":"13","author":"Hammig","year":"2013","journal-title":"BMC Public Health."},{"issue":"3","key":"2020110613033896700_ocv088-B3","first-page":"267","article-title":"Employment conditions as social determinants of health","volume":"16","author":"Lahiri","year":"2006","journal-title":"Part I: the external domain. New Solut."},{"issue":"4","key":"2020110613033896700_ocv088-B4","doi-asserted-by":"crossref","first-page":"429","DOI":"10.2190\/R8Q2-41L5-H4W5-7838","article-title":"A review of employment conditions as social determinants of health part II: the workplace","volume":"16","author":"Moure-Eraso","year":"2006","journal-title":"New Solutions."},{"issue":"2","key":"2020110613033896700_ocv088-B5","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s00420-008-0320-6","article-title":"Occupational class inequalities in health across employment sectors: the contribution of working conditions","volume":"82","author":"Lahelma","year":"2009","journal-title":"IntArch Occup Environ Health."},{"issue":"6","key":"2020110613033896700_ocv088-B6","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/jech.2005.044727","article-title":"Childhood socioeconomic circumstances predict specific causes of death in adulthood: the Glasgow student cohort study","volume":"60","author":"Galobardes","year":"2006","journal-title":"J Epidemiol Commun Health."},{"issue":"12","key":"2020110613033896700_ocv088-B7","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1136\/jech.56.12.922","article-title":"Change in health inequalities among British civil servants: the Whitehall II study","volume":"56","author":"Ferrie","year":"2002","journal-title":"J Epidemiol Commun Health."},{"issue":"3","key":"2020110613033896700_ocv088-B8","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1136\/jech.2004.022574","article-title":"Neighbourhood unemployment and all cause mortality: a comparison of six countries","volume":"59","author":"van Lenthe","year":"2005","journal-title":"J Epidemiol Commun Health."},{"issue":"3","key":"2020110613033896700_ocv088-B9","doi-asserted-by":"crossref","first-page":"465","DOI":"10.2105\/AJPH.91.3.465a","article-title":"A definition of \u201csocial environment''","volume":"91","author":"Barnett","year":"2001","journal-title":"Am J Public Health."},{"key":"2020110613033896700_ocv088-B10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1177\/00333549111260S313","article-title":"Changing disparities in invasive pneumococcal disease by socioeconomic status and race\/ ethnicity in Connecticut, 1998-2008","volume":"126","author":"Soto","year":"2011","journal-title":"Public Health Rep."},{"issue":"7066","key":"2020110613033896700_ocv088-B11","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1136\/bmj.313.7066.1177","article-title":"Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study","volume":"313","author":"Marmot","year":"1996","journal-title":"BMJ."},{"key":"2020110613033896700_ocv088-B12","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780195138382.001.0001","volume-title":"Neighborhoods and Health","author":"Kawachi","year":"2003"},{"issue":"10R","key":"2020110613033896700_ocv088-B13","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1001\/jama.291.10.1238","article-title":"Actual causes of death in the United States, 2000","volume":"291","author":"Mokdad","year":"2004","journal-title":"JAMA."},{"key":"2020110613033896700_ocv088-B14"},{"key":"2020110613033896700_ocv088-B15"},{"issue":"1","key":"2020110613033896700_ocv088-B16","doi-asserted-by":"crossref","first-page":"22","DOI":"10.3122\/jabfm.2010.01.090097","article-title":"Harnessing Geographic Information Systems (GIS) to enable community-oriented primary care","volume":"23","author":"Bazemore","year":"2010","journal-title":"J Am Board Fam Med."},{"key":"2020110613033896700_ocv088-B17","volume-title":"Community-Oriented Primary Care: From Principle to Practice","author":"Nutting","year":"1990"},{"issue":"5","key":"2020110613033896700_ocv088-B18","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1093\/ije\/dyg291","article-title":"Sidney Kark's contributions to epidemiology and community medicine","volume":"32","author":"Kark","year":"2003","journal-title":"Int J Epidemiol."},{"issue":"11","key":"2020110613033896700_ocv088-B19","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.2105\/AJPH.92.11.1713","article-title":"Community-oriented primary care: a path to community development","volume":"92","author":"Geiger","year":"2002","journal-title":"Am J Public Health."},{"issue":"5","key":"2020110613033896700_ocv088-B20","doi-asserted-by":"crossref","DOI":"10.2105\/AJPH.2004.060822","article-title":"Community-oriented primary care and primary health care","volume":"95","author":"Gofin","year":"2005","journal-title":"Am J Public Health."},{"issue":"22","key":"2020110613033896700_ocv088-B21","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1056\/NEJMp1003729","article-title":"Health care reform and primary care\u2013the growing importance of the community health center","volume":"362","author":"Adashi","year":"2010","journal-title":"New Engl J Med."},{"issue":"3","key":"2020110613033896700_ocv088-B22","first-page":"427","article-title":"An integrated medical record and data system for primary care. Part 5: Implications of filing family folders by area of residence","volume":"5","author":"Farley","year":"1977","journal-title":"J Fam Pract."},{"issue":"2","key":"2020110613033896700_ocv088-B23","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1093\/oxfordjournals.aje.a114230","article-title":"Cardiovascular disease risk factors and mortality among black women and white women aged 40-64 years in Evans County, Georgia","volume":"123","author":"Johnson","year":"1986","journal-title":"Am J Epidemiol."},{"issue":"2\u20133","key":"2020110613033896700_ocv088-B24","first-page":"313","article-title":"Relationships between selenium and other parameters in drinking water and blood of subjects from high and low cardiovascular disease rate areas of Georgia","volume":"4","author":"Andrews","year":"1980","journal-title":"J Environ Pathol Toxicol."},{"key":"2020110613033896700_ocv088-B25","volume-title":"Medical Records, Medical Education and Patient Care","author":"Weed","year":"1969"},{"issue":"4","key":"2020110613033896700_ocv088-B26","doi-asserted-by":"crossref","first-page":"590","DOI":"10.2105\/AJPH.2009.185652","article-title":"A framework for public health action: the health impact pyramid","volume":"100","author":"Frieden","year":"2010","journal-title":"Am J Public Health."},{"key":"2020110613033896700_ocv088-B27"},{"key":"2020110613033896700_ocv088-B28","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1097\/01.PHH.0000338382.36695.42","article-title":"Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities","volume":"14","author":"Williams","year":"2008","journal-title":"J Public Health Manag Pract."},{"key":"2020110613033896700_ocv088-B29","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/00333549111260S310","article-title":"Incorporating geospatial capacity within clinical data systems to address social determinants of health","volume":"126","author":"Comer","year":"2011","journal-title":"Public Health Rep."},{"key":"2020110613033896700_ocv088-B30"},{"key":"2020110613033896700_ocv088-B31"},{"issue":"2 Pt 1","key":"2020110613033896700_ocv088-B32","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1475-6773.2012.01449.x","article-title":"Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery","volume":"48","author":"Butler","year":"2013","journal-title":"Health Services Res."},{"key":"2020110613033896700_ocv088-B33"},{"issue":"4","key":"2020110613033896700_ocv088-B34","first-page":"591","article-title":"The ADVANCE network: accelerating data value across a national community health center network","volume":"21","author":"DeVoe","year":"2014","journal-title":"JAMIA."},{"issue":"11","key":"2020110613033896700_ocv088-B35","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.2105\/AJPH.91.11.1783","article-title":"Investigating neighborhood and area effects on health","volume":"91","author":"Diez Roux","year":"2001","journal-title":"Am J Public Health."},{"issue":"2","key":"2020110613033896700_ocv088-B36","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1056\/NEJM200107123450205","article-title":"Neighborhood of residence and incidence of coronary heart disease","volume":"345","author":"Diez Roux","year":"2001","journal-title":"New Engl J Med."},{"issue":"6","key":"2020110613033896700_ocv088-B37","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S1047-2797(01)00221-6","article-title":"Area characteristics and individual-level socioeconomic position indicators in three population-based epidemiologic studies","volume":"11","author":"Diez-Roux","year":"2001","journal-title":"Ann Epidemiol."},{"issue":"10","key":"2020110613033896700_ocv088-B38","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1016\/j.socscimed.2004.03.017","article-title":"The association of personal and neighborhood socioeconomic indicators with subclinical cardiovascular disease in an elderly cohort. The cardiovascular health study","volume":"59","author":"Nordstrom","year":"2004","journal-title":"Soc Sci Med."},{"issue":"6","key":"2020110613033896700_ocv088-B39","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1212\/WNL.0b013e31828154ae","article-title":"Neighborhood socioeconomic disadvantage and mortality after stroke","volume":"80","author":"Brown","year":"2013","journal-title":"Neurology."},{"issue":"1","key":"2020110613033896700_ocv088-B40","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/MLR.0b013e3182349b97","article-title":"Validation of a neighborhood SES index in a managed care organization","volume":"51","author":"Roblin","year":"2013","journal-title":"Medical Care."},{"issue":"5","key":"2020110613033896700_ocv088-B41","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.2337\/dc11-1866","article-title":"Neighborhood deprivation and change in BMI among adults with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE)","volume":"36","author":"Stoddard","year":"2013","journal-title":"Diabetes Care."},{"issue":"7","key":"2020110613033896700_ocv088-B42","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1016\/j.socscimed.2011.11.036","article-title":"Place matters: neighborhood deprivation and cardiometabolic risk factors in the Diabetes Study of Northern California (DISTANCE)","volume":"74","author":"Laraia","year":"2012","journal-title":"Soc Sci Med."},{"key":"2020110613033896700_ocv088-B43","doi-asserted-by":"crossref","DOI":"10.1155\/2011\/846263","article-title":"Prostate cancer severity associations with neighborhood deprivation","author":"Zeigler-Johnson","year":"2011","journal-title":"Prostate Cancer."},{"issue":"6","key":"2020110613033896700_ocv088-B44","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s11524-006-9094-x","article-title":"The development of a standardized neighborhood deprivation index","volume":"83","author":"Messer","year":"2006","journal-title":"J Urban Health."},{"key":"2020110613033896700_ocv088-B45"},{"key":"2020110613033896700_ocv088-B46"},{"key":"2020110613033896700_ocv088-B47"},{"key":"2020110613033896700_ocv088-B48","article-title":"Place matters: the problems and possibilities of spatial data in electronic health records","author":"Simpson","year":"2013","journal-title":"AMIA Ann Symp Proc."},{"issue":"2","key":"2020110613033896700_ocv088-B49","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1370\/afm.1495","article-title":"The primary care extension program: a catalyst for change","volume":"11","author":"Phillips","year":"2013","journal-title":"Ann Fam Med."},{"key":"2020110613033896700_ocv088-B50"},{"key":"2020110613033896700_ocv088-B51"},{"key":"2020110613033896700_ocv088-B52"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/23\/2\/407\/34147694\/ocv088.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/23\/2\/407\/34147694\/ocv088.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T02:53:51Z","timestamp":1652842431000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/23\/2\/407\/2572403"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,13]]},"references-count":52,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2015,7,13]]},"published-print":{"date-parts":[[2016,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocv088","relation":{},"ISSN":["1527-974X","1067-5027"],"issn-type":[{"value":"1527-974X","type":"electronic"},{"value":"1067-5027","type":"print"}],"subject":[],"published-other":{"date-parts":[[2016,3]]},"published":{"date-parts":[[2015,7,13]]}}}