ABSTRACT:
Background. Viewing privilege as a social determinant of health provides a useful lens for examining how social, economic, and structural advantages shape health outcomes. Our team developed and piloted a privilege questionnaire with questions related to SDOH so that respondents receive a composite privilege score ranging from −464 (lower privilege and access) to 464 (higher privilege and access). The primary purpose of this study was to explore the relationship between social privilege and health outcomes with primary care patients. Methods. In summer 2025, participants were recruited for three focus groups (FGs). During FGs, participants (1) completed the electronic index and (2) shared perspectives related to measuring privilege in healthcare. Data were collected via REDCap and then downloaded and analyzed in Excel and SPSS. Given the small sample size, adjusted analyses were limited and considered exploratory. The university Institutional Review Board approved the study. Results. Sixteen participants were included (mean age = 52.9 years). Most identified as Black/African American or multiracial (69%) and female (69%). A majority had some college education (62.5%) and reported annual incomes below $50,000 (81.2%). Common health conditions included hypertension (62.5%), high cholesterol (56.2%), and Type 2 Diabetes (50%). The average privilege score was -7.75. Lower privilege scores were correlated with increased likelihood of asthma (p=0.007), more likely to have government insurance (p=0.005), and more likely to report high cholesterol (p=0.016), food insecurity (p=0.020), and mood disorders (p=0.024). Conclusion. Our preliminary findings show that in-depth patient narratives related to social determinants of health can be translated into a numeric measure of privilege and access (or lack thereof), creating a mixed-methods tool that links lived experience to health outcomes. This approach supports Health Without Borders by offering a practical, values-driven framework, capturing upstream conditions influencing risk, resources, and well-being, to inform policies and practice across diverse health systems.