It is estimated that 80% of a person’s health outcomes are related to social factors outside of their control. These social determinants of health are the nonmedical factors that influence a person’s health, including the conditions in which they are born, live, work, and age. In 2021, CIVHC took a big step to enhance the CO APCD and its capacity to report on these social conditions by geocoding the database. The CO APCD can now provide deeper, more insightful analyses into health equity across the state and is one of the few APCDs in the country with this capability.

Geocoding is the process of tagging each person represented in the CO APCD with latitude and longitude coordinates. This allows CIVHC analysts to link member and provider addresses to data sources at different geography levels, including the census tract level. While the CO APCD is able to report data at county and zip code levels, linking data at the census tract level significantly increases the specificity and accuracy capabilities of the CO APCD. At the census tract level, data is broken into small “neighborhoods” comprising an average of 4,000 people, and no more than 8,000, allowing for heightened insights and precise geographic analysis.


A side-by-side comparison of two maps of Colorado. The left map is titled 'Colorado County-level Data' and depicts the state divided into counties, each outlined and labeled with names such as Moffat, Larimer, and Denver. The counties are shaded in various tones of orange, indicating different data points or values. The right map, titled 'Colorado Census Tract Data', shows a more detailed division into census tracts with a similar color scheme, emphasizing the density of data points in urban areas like Denver, represented with finer lines and smaller regions.

Geocoding also opens the door to linking CO APCD data to other data sources to investigate socio-economic factors on health. Through the geocoded socio-economic background score (GSB) CIVHC created, analysts can now overlay claims data with other data sets, such as the American Community Survey (ACS) and the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index, to report on the intersection of social determinant of health factors such as income level, housing status, race and ethnicity, and health outcomes.

Health Equity Analytics in Public Reporting

CIVHC used these capabilities in a public report for the first time with the Health Equity Analysis, released in spring 2023. The innovative analysis investigates the relationship between key social factors and the access and use of health care services measured on the Community Dashboard.

A graphical table titled 'STATEWIDE Relationship Table' illustrating the relationship between health care measures and social factors. The table uses colored dots to represent the strength of relationships: red for strong, orange for moderate, and green for weak. Rows represent health care measures like Access to Care for Children & Adolescents, Adults, Follow-Up After ED Visit for Mental Health, Cost of Care per Person per Year, and Potentially Preventable ED Visits. Columns represent social factors including Income, Education, Employment, Housing/Transportation, and Race/Ethnicity/Language. Each cell contains a colored dot indicating the strength of the relationship between the corresponding health measure and social factor.

Socio-economic measures included in the report (income; education; employment status; housing and transportation; race, ethnicity and language) were derived from the ACS and the CDC Social Vulnerability Index, marking the first time outside data sources were incorporated into a CIVHC report and demonstrating the power of analysis provided by a geocoded CO APCD.

In early 2024, CIVHC released the second public report to use health equity analytics with the Telehealth Equity Analysis. Similar to the Health Equity Analysis, this report pairs CO APCD data with U.S. Census data to investigate the relationship between social determinants, such as transportation and internet connectivity, and telehealth usage at the neighborhood level to identify barriers to access.

An overview graphic of the 'Telehealth Equity Analysis'. The left side features a partial map of Colorado with a highlighted icon of a smartphone displaying a medical cross, indicating the focus on telehealth. The right side, titled 'STATEWIDE Insights and Findings', lists significant social factors impacting telehealth visit rates: Lack of Computers, Lack of Smartphones, Lack of Access to a Vehicle, and Veterans. Each factor is noted to have a moderate relationship with telehealth usage rates. The content emphasizes the potential of telehealth to improve access to care and advance health equity, particularly in rural and under-resourced communities in Colorado.

CIVHC will continue to update the CO APCD geocoding each year and continue to work to identify opportunities to further integrate geocoded data into future reporting and analyses as appropriate. Through these innovative steps, the CO APCD continues to grow in exciting ways that allows it to stand out in its scope, comprehensibility, and utility.

For questions related to social determinant of health data and reporting, contact us at