Evidence map›Paper›PMID 40713662›Full record

ArticleBiology of sex differences2025

A comparison of social drivers of health identification and intervention rates by sex among patients receiving primary care.

Leah A Holcomb, Elizabeth Crabtree Killen, Kelsey R Ryan, Aimee L McRae-Clark, Stacey Seipel, Rita Aidoo, Constance Guille

Abstract readComparative Study
In one paragraph

Article in Biology of sex differences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Leah A HolcombDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. holcomle@musc.edu.
Elizabeth Crabtree KillenDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Kelsey R RyanPopulation Health, Medical University Hospital Authority Benefits Department, Medical University of South Carolina, Charleston, SC, USA.
Aimee L McRae-ClarkDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Stacey SeipelDepartment of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
Rita AidooDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Constance GuilleDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSocial drivers of health (SDOH) significantly influence health behaviors and outcomes, yet sex-based disparities in these domains remain underexplored. Identifying these differences is essential for guiding equitable, evidence-based interventions.

methodsWe analyzed electronic health record (EHR) data from all patients with a documented male or female sex who had a primary care visit or inpatient stay at the Medical University of South Carolina (MUSC) between January 1, 2023, and December 31, 2024 (n = 493,920). SDOH screening responses were categorized as "affirmative" (at risk) or "negative" (not at risk) across 17 predefined domains using Epic's logic-based risk classification. Descriptive statistics were calculated, and z-tests for proportions were used to assess sex-based differences. Race and ethnicity were included as descriptive variables; no inferential tests by race/ethnicity were conducted.

resultsFemales were significantly more likely to report financial strain (7.96%), food insecurity (4.44%), housing instability (3.72%), intimate partner violence (2.03%), transportation barriers (2.20%), depression (3.93%), and stress (14.10%). Despite these risks, females also reported higher rates of protective behaviors such as physical activity (74.2%) and social connectedness (14.22%). In contrast, males had higher rates of alcohol use (4.67%), tobacco use (35.6%), and adolescent substance use (2.14%). Notably, White/Caucasian males reported the highest alcohol use (6.23%), and both White and Black males reported the highest tobacco use (42%).

conclusionsSex-based disparities in SDOH reflect broader structural and social inequities. Health systems should implement routine, EHR-integrated SDOH screening and use this data to inform tailored, gender-responsive interventions-such as increasing access to mental health support for women and addressing substance use among men-while also considering how intersecting factors like race, income, and caregiving burden compound these risks.

Indexed as

Primary Health CareAdolescentAdultFemaleHealth Services AccessibilityHumansMaleMiddle AgedRacial GroupsRisk FactorsSex CharacteristicsSex FactorsYoung AdultGenderSexSocial determinants of healthSocial drivers of health

Identifiers

PMID40713662
PMCPMC12291404

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.