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. Author manuscript; available in PMC: 2024 Aug 1.
Published in final edited form as: Soc Sci Med. 2023 Jul 17;331:116095. doi: 10.1016/j.socscimed.2023.116095

Table 2.

Domains and Selected Social Structural Outer Context Common Data Elements (SC-CDE) of Interest

Domain Example Measures County-level measure included in this analysis
Food

  • Grocery Store Access

  • % on SNAP

  • Modified Retail Food Environment Index

  • Supermarkets and Other Grocery (except Convenience) Stores (total and per 100,000 population)

  • Percent of people living more than 1 mile from a supermarket or large grocery store if in an urban area, or more than 10 miles from a supermarket or large grocery store if in a rural area. Obtained from the 2015 USDA Food Atlas.
Physical

  • Access to parks and recreation spaces

  • Urban classification code

  • Housing (e.g., modernity, ownership)

  • Crime

  • Pollution

  • Infrastructure

  • Percentage of population living within half a mile of a park. Obtained from CDC’s National Environmental Public Health Tracking Network, 2015.

  • Percentage of households with no broadband obtained from American Community Survey (ACS), 2016-2020.
Economic

  • Poverty and employment

  • Residential housing (e.g., foreclosures, mortgages, vacancies, evictions, costs, lending)

  • Commercial real estate (e.g., vacancies, density)

  • Percentage of population unemployed. Obtained from ACS, 2016-2020.

  • Percentage of population below 200% of Federal Poverty Level. Obtained from ACS, 2016-2020.

  • Social deprivation index, a composite measure of area level deprivation derived from seven demographic characteristics collected in the American Community Survey. Higher scores indicate greater deprivation. Index obtained from the Robert Graham Center, 2019.
Social

  • Population characteristics (e.g., density, racial/ethnic composition, segregation)

  • Education (e.g., % with high school diploma)

  • Language (e.g., % with limited English proficiency)

  • Transportation (e.g., % with access to a car)

  • Percent of households with no vehicle. Obtained from ACS 2015-2019

  • Median monthly housing costs. Obtained from ACS 2016-2020
Health status and Healthcare

  • % in poor physical or mental health

  • % with disability

  • Access to care (e.g., primary care provider density, health insurance)

  • Percentage of adults with no usual source of care. Obtained from BRFSS, 2017
Cancer health behaviors and screening

  • Proportion of population with cancer risk factors (e.g., smoking, overweight/obesity, fruit & veg intake, physical activity, alcohol intake)

  • % Not current with cancer screening, overall and by type

  • Extent of disparities in cancer screening, overall and by type

  • % Completed HPV vaccination

  • Extent of disparities in HPV vaccination completion

  • Average percentage of Medicare enrollees age 67-69 having at least one mammogram over a two-year period, 2019. Obtained from Dartmouth Atlas.

  • Age-adjusted prevalence of fecal occult blood test, sigmoidoscopy, or colonoscopy among adults aged 50-75 years, 2018. Obtained from CDC PLACES.
Cancer-related policies

  • Medicaid expansion

  • Medicaid coverage of comprehensive tobacco treatment

  • Local and state tobacco policies

  • State SNAP incentive programs for fruit and vegetable access

  • Smokefree Requirements for bars, restaurants, and workplaces. Obtained from NCI GIS Portal for Cancer Research Website Tobacco Policy.