Social, psychological and behavioral observations (19 questions)

This group of 19 questions is used for screening for social and behavioural risks for health. It consists of several brief measures combined together in one panel, including general health, alcohol use, exercise, food security, income and education. The questions are rated according to different scales – see this online form for details.

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This panel of 19 questions summarizes the main social and behavioural risks of health. It can be used to assess the overall risk level of a program’s client population. Some of the questions can track outcomes over time.


  • How hard is it for you to pay for the very basics like food, housing, medical care, and heating?
  • What is the highest grade or level of school you have completed or the highest degree you have received?
  • Stress means a situation in which a person feels tense, restless, nervous, or anxious, or is unable to sleep at night because his/her mind is troubled all the time. Do you feel this kind of stress these days?
  • Little interest or pleasure in doing things?
  • Feeling down, depressed, or hopeless?
  • How many days of moderate to strenuous exercise, like a brisk walk, did you do in the last 7 days?
  • On those days that you engage in moderate to strenuous exercise, how many minutes, on average, do you exercise?
  • How often do you have a drink containing alcohol?
  • How many standard drinks containing alcohol do you have on a typical day?
  • How often do you have 6 or more drinks on 1 occasion?
  • Are you now married, widowed, divorced, separated, never married or living with a partner?
  • In a typical week, how many times do you talk on the telephone with family, friends, or neighbors?
  • How often do you get together with friends or relatives?
  • How often do you attend church or religious services?
  • Do you belong to any clubs or organizations such as church groups unions, fraternal or athletic groups, or school groups?
  • Within the last year, have you been humiliated or emotionally abused in other ways by your partner or ex-partner?
  • Within the last year, have you been afraid of your partner or ex-partner?
  • Within the last year, have you been raped or forced to have any kind of sexual activity by your partner or ex-partner?
  • Within the last year, have you been kicked, hit, slapped, or otherwise physically hurt by your partner or ex-partner?


This set of questions comprises several brief measures covering a broad range of health risks and determinants. The panel of 19 questions is recommended by the U.S. National Coordinator for Health Information Technology to promote interoperability between clinical health information systems, and to encourage more attention to social and behavioural determinants in health services.


The panel is quite long and may not be exactly relevant to many programs. For example, it asks about alcohol use but not other substances. In addition, some of the questions are not likely to change over time (e.g., “what is the highest grade or level of school you have completed…”) Users may wish to use to combine other measures from LOINC to fit their needs.

Method of measurement

The scoring for this panel is complex since the questions use various scales and there is no single score. Read the LOINC reference for instructions. The high cost for this measure reflects the complexity of the data visualizations; there will likely be several different graphs and filters.


Social, psychological & behavioral observations – 2015 Edition Health IT Certification Criteria set. From

2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications Final Rule – October 16, 2015.


Additional information