Abstract
We assessed the appropriate geographic scale to apply an area deprivation index (ADI), which reflects a geographic area’s level of socioeconomic deprivation and is associated with health outcomes, to identify and screen patients for social determinants of health. We estimated the relative strength of the association between the ADI at various geographic levels and a range of hospitalization rates by using age-adjusted odds ratios in an 8-county region of New York State. The 10-km local ADI estimates had the strongest associations with all hospitalization rates (higher odds ratios) followed by estimates at 20 km, 30 km, and the regional scale. A locally sensitive ADI is an ideal measure to identify and screen for the health care and social services needs and to advance the integration of social determinants of health with clinical treatment and disease prevention.
Highlights
An area deprivation index (ADI) is a multidimensional evaluation of a region’s socioeconomic conditions, which have been linked to health outcomes [1,2,3,4,5,6]
We examined the relative strength of the association between a locally calibrated ADI with regional scale metrics and 4 hospitalization rates in New York’s Hudson Valley, an area that comprises 8 counties and is home to 2.3 million residents
The 10-km local ADI estimates had the strongest associations with all hospitalization rates followed by estimates at 20 km, 30 km, and the regional scale, respectively (Table)
Summary
As the health care system shifts toward value-based planning and purchasing, new tools are needed to integrate social determinants of health into clinical and preventive care to improve population health and reduce health care disparities. An area deprivation index (ADI) is a multidimensional evaluation of a region’s socioeconomic conditions, which have been linked to health outcomes [1,2,3,4,5,6]. We have refined the ADI, testing its association with health outcomes at various geographic levels. A simple-to-use tool such as the ADI can provide an efficient mechanism to alert health care providers to screen and refer patients for problems related to social determinants of health
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