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The Association between Social Determinants of Health, Risk Factors, Job Performance and Healthcare Costs in an Employed Population.

OBJECTIVE: To compare employees of a US school district based on their social determinants of health (SDoH).

METHODS: Employees (N = 5006) were categorized into low, medium, or high need SDoH tiers. Of them, N = 2469 also participated in a health risk appraisal in 2019. Subjects' average healthcare costs, health risk factors, and self-rated job performance were compared by SDoH tier and race.

RESULTS: Significant differences were observed among the SDoH comparison groups regarding age, gender, race, and marital status. SDoH was associated with health care costs, number of health risk factors, and self-rated job performance differently for Black and White employees.

CONCLUSIONS: SDoH are complex and multi-faceted. Black employees in the high need SDoH group had higher average healthcare costs, lower self-rated job performance, and more average health risk factors than subjects in the lower need tiers.

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