Abstract P450: Assessing Admission Risk in Under-Resourced Neighborhoods: An Analysis by Race

Abstract

Introduction: Cardiovascular disease (CVD) disproportionately affects socioeconomically disadvantaged communities and people of racial minority backgrounds. The Area Deprivation Index (ADI) is a validated measure of census-level characteristics based on income, education, employment, housing, and more. Although ADI is often linked to adversity, it is less well known if ADI is associated with racial disparities in CVD admission among cardiac patients living in disadvantaged communities. Hypothesis: We hypothesized that among a cohort of cardiac patients, risk for CVD admissions would be associated with ADI and that risk would vary by race. Methods: We identified ADI among n=27694 patients receiving care in a large health care system. We compared individual’s demographic variables using chi square for categorical variables and t-test for continuous variables. Using, ANOVA we determined differences in ADI by race. We further used ADI to identify neighborhoods with disproportionate rates CVD admissions using linear regression. Results: Figure Panel A shows that the ADI of American Indians, Blacks, and Asians was higher compared with that of Whites. Completion of an ANOVA test provided a p-value <0.05, showing that the average ADI is not equal between race groups. Panel B shows a linear association between higher ADI and increased risk of CVD event. Yet, some block groups were outliers with lower than predicted CVD events, labeled as low utilizers. Conclusion and Implications: Racial minority groups tended to have a higher ADI, yet some groups at high risk for CVD had disproportionately lower CVD events. These findings along with our team’s future work will inform interventions to address neighborhood level social determinants of cardiac health. Interventions that account for the unique social and healthcare contexts and inequities specific to at-risk communities will in turn help address the health challenges unique to these groups.