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Social Indicators Research

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24-08-2023 | Original Research

Feasibility and Validity of Using Item Response Theory to Assess Cumulative Social Risk

Authors: Salene M.W. Jones, Katherine J. Briant, Cecy Corona, Jason A. Mendoza

Published in: Social Indicators Research | Issue 3/2023

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Abstract

Social risks are patient-level effects of social determinants of health. Cumulative social risk, the total of multiple risks, predicts health outcomes such as cancer mortality. Current measures of cumulative social risk count the number of domains in which a patient has risks. We tested whether an item response theory (IRT) model could be an alternative method for measuring cumulative social risk. A population-based sample (n = 1118) was recruited from 13 counties of western Washington State. Participants completed a one-time survey online. Questions on social risk included two on housing instability, two on food insecurity, one on affording medical care and one on general financial health. Additional measures to test the construct validity of the cumulative social risk score included perceived discrimination, perceived stress, smoking status and having a usual place for healthcare. The IRT model fit the six social risk items. Social risk items ranged in severity from just above the mean (0.18 standard deviations) to substantially above the mean (4.18 standard deviations). IRT scores were positively and significantly associated with perceived discrimination (p < 0.001), perceived stress (p < 0.001), being a current smoker vs. a never (p < 0.001) or former smoker (p = 0.006) and not having a usual place for healthcare vs. having a usual place of care (p = 0.033). Cumulative social risk can be measured and assessed using IRT models. Weighted IRT cumulative social risk scores were associated with multiple health markers, indicating promise for this type of measure. Future research is needed to compare IRT-based and count-based cumulative social risk scores.

previous article Trajectories of Latent Vulnerability and Distress: Identifying Social and Spatial Fringes of the Swedish Population

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Title: Feasibility and Validity of Using Item Response Theory to Assess Cumulative Social Risk
Authors: Salene M.W. Jones
Katherine J. Briant
Cecy Corona
Jason A. Mendoza
Publication date: 24-08-2023
Publisher: Springer Netherlands
Published in: Social Indicators Research / Issue 3/2023
Print ISSN: 0303-8300
Electronic ISSN: 1573-0921
DOI: https://doi.org/10.1007/s11205-023-03189-4

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