Background: Understanding social determinants of health (SDoH) factors contributing to suicide incidents is crucial for early intervention and prevention. However, data-driven approaches to this goal face challenges such as long-tailed factor distributions, analyzing pivotal stressors preceding suicide incidents, and limited model explainability. Methods: We present a multi-stage large language model framework to enhance SDoH factor extraction from unstructured text. Our approach was compared to other state-of-the-art language models (i.e., pre-trained BioBERT and GPT-3.5-turbo) and reasoning models (i.e., DeepSeek-R1). We also evaluated how the model's explanations help people annotate SDoH factors more quickly and accurately. The analysis included both automated comparisons and a pilot user study. Results: We show that our proposed framework demonstrated performance boosts in the overarching task of extracting SDoH factors and in the finer-grained tasks of retrieving relevant context. Additionally, we show that fine-tuning a smaller, task-specific model achieves comparable or better performance with reduced inference costs. The multi-stage design not only enhances extraction but also provides intermediate explanations, improving model explainability. Conclusions: Our approach improves both the accuracy and transparency of extracting suicide-related SDoH from unstructured texts. These advancements have the potential to support early identification of individuals at risk and inform more effective prevention strategies.

Alzheimer's disease and related dementias (AD/ADRD) represent a growing healthcare crisis affecting over 6 million Americans. While genetic factors play a crucial role, emerging research reveals that social determinants of health (SDOH) significantly influence both the risk and progression of cognitive functioning, such as cognitive scores and cognitive decline. This report examines how these social, environmental, and structural factors impact cognitive health trajectories, with a particular focus on Hispanic populations, who face disproportionate risk for AD/ADRD. Using data from the Mexican Health and Aging Study (MHAS) and its cognitive assessment sub study (Mex-Cog), we employed ensemble of regression trees models to predict 4-year and 9-year cognitive scores and cognitive decline based on SDOH. This approach identified key predictive SDOH factors to inform potential multilevel interventions to address cognitive health disparities in this population. Introduction Alzheimer's disease and related dementias (AD/ADRD) pose an escalating medical and public health challenge, currently affecting over 6 million Americans.

Social determinants of health (SDoH) play a crucial role in patient health outcomes, yet their integration into biomedical knowledge graphs remains underexplored. This study addresses this gap by constructing an SDoH-enriched knowledge graph using the MIMIC-III dataset and PrimeKG. We introduce a novel fairness formulation for graph embeddings, focusing on invariance with respect to sensitive SDoH information. Via employing a heterogeneous-GCN model for drug-disease link prediction, we detect biases related to various SDoH factors. To mitigate these biases, we propose a post-processing method that strategically reweights edges connected to SDoHs, balancing their influence on graph representations. This approach represents one of the first comprehensive investigations into fairness issues within biomedical knowledge graphs incorporating SDoH. Our work not only highlights the importance of considering SDoH in medical informatics but also provides a concrete method for reducing SDoH-related biases in link prediction tasks, paving the way for more equitable healthcare recommendations. Our code is available at \url{https://github.com/hwq0726/SDoH-KG}.

Recent advancements in large language models have demonstrated their potential in numerous medical applications, particularly in automating clinical trial matching for translational research and enhancing medical question answering for clinical decision support. However, our study shows that incorporating non decisive sociodemographic factors such as race, sex, income level, LGBT+ status, homelessness, illiteracy, disability, and unemployment into the input of LLMs can lead to incorrect and harmful outputs for these populations. These discrepancies risk exacerbating existing health disparities if LLMs are widely adopted in healthcare. To address this issue, we introduce EquityGuard, a novel framework designed to detect and mitigate the risk of health inequities in LLM based medical applications. Our evaluation demonstrates its efficacy in promoting equitable outcomes across diverse populations.

Growing evidence suggests that social determinants of health (SDoH), a set of nonmedical factors, affect individuals' risks of developing Alzheimer's disease (AD) and related dementias. Nevertheless, the etiological mechanisms underlying such relationships remain largely unclear, mainly due to difficulties in collecting relevant information. This study presents a novel, automated framework that leverages recent advancements of large language model (LLM) and natural language processing techniques to mine SDoH knowledge from extensive literature and integrate it with AD-related biological entities extracted from the general-purpose knowledge graph PrimeKG. Utilizing graph neural networks, we performed link prediction tasks to evaluate the resultant SDoH-augmented knowledge graph. Our framework shows promise for enhancing knowledge discovery in AD and can be generalized to other SDoH-related research areas, offering a new tool for exploring the impact of social determinants on health outcomes. Our code is available at: https://github.com/hwq0726/SDoHenPKG

Social and behavioral determinants of health (SDOH) play a significant role in shaping health outcomes, and extracting these determinants from clinical notes is a first step to help healthcare providers systematically identify opportunities to provide appropriate care and address disparities. Progress on using NLP methods for this task has been hindered by the lack of high-quality publicly available labeled data, largely due to the privacy and regulatory constraints on the use of real patients' information. This paper introduces a new dataset, SDOH-NLI, that is based on publicly available notes and which we release publicly. We formulate SDOH extraction as a natural language inference (NLI) task, and provide binary textual entailment labels obtained from human raters for a cross product of a set of social history snippets as premises and SDOH factors as hypotheses. Our dataset differs from standard NLI benchmarks in that our premises and hypotheses are obtained independently. We evaluate both "off-the-shelf" entailment models as well as models fine-tuned on our data, and highlight the ways in which our dataset appears more challenging than commonly used NLI datasets.

We aimed to investigate the impact of social circumstances on cancer therapy selection using natural language processing to derive insights from social worker documentation. We developed and employed a Bidirectional Encoder Representations from Transformers (BERT) based approach, using a hierarchical multi-step BERT model (BERT-MS) to predict the prescription of targeted cancer therapy to patients based solely on documentation by clinical social workers. Our corpus included free-text clinical social work notes, combined with medication prescription information, for all patients treated for breast cancer. We conducted a feature importance analysis to pinpoint the specific social circumstances that impact cancer therapy selection. Using only social work notes, we consistently predicted the administration of targeted therapies, suggesting systematic differences in treatment selection exist due to non-clinical factors. The UCSF-BERT model, pretrained on clinical text at UCSF, outperformed other publicly available language models with an AUROC of 0.675 and a Macro F1 score of 0.599. The UCSF BERT-MS model, capable of leveraging multiple pieces of notes, surpassed the UCSF-BERT model in both AUROC and Macro-F1. Our feature importance analysis identified several clinically intuitive social determinants of health (SDOH) that potentially contribute to disparities in treatment. Our findings indicate that significant disparities exist among breast cancer patients receiving different types of therapies based on social determinants of health. Social work reports play a crucial role in understanding these disparities in clinical decision-making.

There is growing evidence showing the significant role of social determinant of health (SDOH) on a wide variety of health outcomes. In the era of artificial intelligence (AI), electronic health records (EHRs) have been widely used to conduct observational studies. However, how to make the best of SDOH information from EHRs is yet to be studied. In this paper, we systematically reviewed recently published papers and provided a methodology review of AI methods using the SDOH information in EHR data. A total of 1250 articles were retrieved from the literature between 2010 and 2020, and 74 papers were included in this review after abstract and full-text screening. We summarized these papers in terms of general characteristics (including publication years, venues, countries etc.), SDOH types, disease areas, study outcomes, AI methods to extract SDOH from EHRs and AI methods using SDOH for healthcare outcomes. Finally, we conclude this paper with discussion on the current trends, challenges, and future directions on using SDOH from EHRs.

Two new and seemingly unrelated approaches to delivering healthcare are starting to take shape in the industry: the use of artificial intelligence, and the integration of social determinants of health in crafting care plans. Both trends are developing independently, but they're likely due to intersect; factoring in SDOH is possible due to data, and if AI shines in any one particular area, it's making sense of complex data sets. If the social determinants are comprised of the socioeconomic factors that can influence a person's health -- income, education, access to transportation, etc. -- then AI has the potential to allow providers to make the best possible use of that information. That becomes increasingly important as value-based care emerges. With reimbursement increasingly tied to health outcomes, providers have a real incentive to ensure they're delivering the best care possible.