In addition to the two coarse-grained categories (SS and SI), we sought to further classify these concepts into distinct fine-grained categories that uniquely impact health and wellbeing [37]. The fine-grained categories are based on the seminal work of House et al. [38] and updated to include what has been researched in healthcare (e.g., social networks) [12]. Our workgroup of clinical psychiatrists and psychologists, psychiatric epidemiologists, sociologists, and biomedical informaticians finalized the categories. There is an inherent degree of overlap and subjectivity between the fine-grained categories, e.g., ‘lives with family’ could conceivably be characterized as instrumental support, emotional support, social network, or perhaps a general category of SS. Therefore, to distinguish between categories we created a clear annotation rule book [38] to ensure consistency, transparency, and reproducibility. The final fine-grained SS subcategories included social network (‘goes to church’), emotional support (‘can talk about her problems’), instrumental support (‘home health aide’), and a general subcategory∗ (‘patient has good social supports’), which is assigned when there are insufficient details to ascertain a category. The final fine-grained SI subcategories included loneliness (‘feelings of loneliness’), no social network (‘socially isolated’), no emotional support (‘no one to confide in’), no instrumental support (‘homeless’), and a general subcategory (‘no social support’). The schema for SS and SI are presented in Figure 1.
Authors:
(1) Braja Gopal Patra, Weill Cornell Medicine, New York, NY, USA and co-first authors;
(2) Lauren A. Lepow, Icahn School of Medicine at Mount Sinai, New York, NY, USA and co-first authors;
(3) Praneet Kasi Reddy Jagadeesh Kumar. Weill Cornell Medicine, New York, NY, USA;
(4) Veer Vekaria, Weill Cornell Medicine, New York, NY, USA;
(5) Mohit Manoj Sharma, Weill Cornell Medicine, New York, NY, USA;
(6) Prakash Adekkanattu, Weill Cornell Medicine, New York, NY, USA;
(7) Brian Fennessy, Icahn School of Medicine at Mount Sinai, New York, NY, USA;
(8) Gavin Hynes, Icahn School of Medicine at Mount Sinai, New York, NY, USA;
(9) Isotta Landi, Icahn School of Medicine at Mount Sinai, New York, NY, USA;
(10) Jorge A. Sanchez-Ruiz, Mayo Clinic, Rochester, MN, USA;
(11) Euijung Ryu, Mayo Clinic, Rochester, MN, USA;
(12) Joanna M. Biernacka, Mayo Clinic, Rochester, MN, USA;
(13) Girish N. Nadkarni, Icahn School of Medicine at Mount Sinai, New York, NY, USA;
(14) Ardesheer Talati, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA and New York State Psychiatric Institute, New York, NY, USA;
(15) Myrna Weissman, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA and New York State Psychiatric Institute, New York, NY, USA;
(16) Mark Olfson, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA, New York State Psychiatric Institute, New York, NY, USA, and Columbia University Irving Medical Center, New York, NY, USA;
(17) J. John Mann, Columbia University Irving Medical Center, New York, NY, USA;
(18) Alexander W. Charney, Icahn School of Medicine at Mount Sinai, New York, NY, USA;
(19) Jyotishman Pathak, Weill Cornell Medicine, New York, NY, USA.
