Social Vulnerability Index Research Articles

Analyzing Fatal Police Shootings: The Roles of Social Vulnerability, Race, and Place in the U.S.

IntroductionSocial vulnerability, race, and place are three important predictors of fatal police shootings. This research offers the first assessment of these factors at the zip code level. MethodsThe 2015-2022 Mapping Police Violence and Washington Post Fatal Force Data (2015-2022) were used and combined with the American Community Survey (2015-2022). The social vulnerability index (SVI) was computed for each zip code by using indicators suggested by CDC, then categorized into low-, medium-, and high-SVI. The analytical file included police officers who fatally shot 6,901 individuals within 32,736 zip codes between 2015-2022. Negative Binomial Regression (NBRG) models were run to estimate the association between number of police shootings and zip code SVI, racial composition, and access to guns using 2015-2022 data. ResultsMoving from low-SVI to high-SVI revealed the number of fatal police shootings increased 8.3 times, with the highest increases in Blacks (20.4 times), and Hispanics (27.1 times). The NBRG showed that moderate-, and high-SVI zip codes experienced higher fatal police shootings by 1.97, and 3.26 times than low-SVI zip codes; zip code racial composition, working age population, number of violent crimes, number of police officers and access to a gun, were other predictors of fatal police shootings. ConclusionsSocial vulnerability and racial composition of a zip code are associated with fatal police shooting, both independently and when considered together. What drives deadly police shootings in the United States is not one single factor, but rather complex interactions between social-vulnerability, race, and place that must be tackled synchronously. Action must be taken to address underlying determinants of disparities in policing.

The need for rural–urban county type in Centers for Disease Control and Prevention’s Social Vulnerability Index concerning human immunodeficiency virus reporting data.

The need for rural–urban county type in Centers for Disease Control and Prevention’s Social Vulnerability Index concerning human immunodeficiency virus reporting data.

Spatial pattern of congenital toxoplasmosis incidence and its relationship with vulnerability and national health indicators in Brazil

There is a gap in evidence regarding spatial clusters of the congenital toxoplasmosis (CT) and its association with social and health indicators in the Brazilian territory. Thus, we aimed herein to identify CT risk areas in Brazil and its association with social vulnerability and health indicators. An ecological and population-based study was conducted. The CT incidence coefficient was calculated and smoothed using the Local Empirical Bayesian method. Global regression models and local spatial regression model were applied. High-incidence clusters of the disease were identified throughout the country. Additionally, a positive association was observed between the incidence of congenital toxoplasmosis and the Social Vulnerability Index, coverage of community health agents, and the percentage of prenatal consultations. This association was stronger the further south in the country. Herewith, the implementation and strengthening of public strategies, with focus on priority intersectoral actions for prevention, early diagnosis, and prompt treatment, is urgently required for the effective control of CT in Brazilian municipalities.

52618 Investigating the role of social vulnerability index in head and neck melanoma in California: A Surveillance, Epidemiology, and End Results (SEER) analysis.

52618 Investigating the role of social vulnerability index in head and neck melanoma in California: A Surveillance, Epidemiology, and End Results (SEER) analysis.

51694 Investigating the role of social vulnerability index in cutaneous-head and neck squamous cell carcinoma in California: A Surveillance, Epidemiology, and End Results (SEER) analysis.

51694 Investigating the role of social vulnerability index in cutaneous-head and neck squamous cell carcinoma in California: A Surveillance, Epidemiology, and End Results (SEER) analysis.

Impact of social vulnerability index on patients with alcohol-related liver disease

IntroductionAlcohol related liver disease (ALD) affects diverse communities with individual and social characteristics that can impact outcomes. The social vulnerability index (SVI) assigns a score between 0 and 1, where higher scores represent an increased risk of social vulnerability. We sought to assess the impact of SVI on outcomes of patients hospitalized with ALD with access to social support services. Methods and materialsHospitalizations for ALD at our institution between March and August 2019 were reviewed. All patients were assigned an SVI score based on their residential census tract. Per our standard practice, patients were screened by care coordinators to identify needs for rehabilitation counseling, and care coordination after discharge. Demographics, hepatic decompensation, critical care needs, readmission, and mortality were compared. ResultsAmong 73 patients admitted for alcoholic hepatitis, 32 had a low SVI and 42 had a high SVI. African American patients were more likely to have a higher SVI (35% vs 0%, p=<0.001). No significant difference in outcomes based on SVI was noted.There were 393 patients admitted for alcoholic cirrhosis including 166 with a low SVI and 227 with a high SVI. Patients that were African American (23.6% vs 5.5%, p=<0.001) or disabled (41.4% vs 29.5%, p = 0.008) had a higher SVI. No significant difference in outcomes based on SVI was noted. ConclusionMost patients admitted for ALD had a high SVI; however, SVI did not impact hospitalization outcomes.

Workplace Exposures Vary Across Neighborhoods in the US: Implications on Social Vulnerability and Racial/Ethnic Health Disparities.

Ignoring workplace exposures that occur beyond the local residential context in place-based risk indices like the CDC's Social Vulnerability Index (SVI) likely misclassifies community exposure by under-counting risks and obscuring true drivers of racial/ethnic health disparities. To investigate this hypothesis, we developed several place-based indicators of occupational exposure and examined their relationships with race/ethnicity, SVI, and health inequities. We used publicly available job exposure matrices and employment estimates from the United States (US) Census to create and map six indicators of occupational hazards for every census tract in the US. We characterized census tracts with high workplace-low SVI scores. We used natural cubic splines to examine tract level associations between the percentage of racial/ethnic minorities (individuals who are not non-Hispanic White) and the occupational indicators. Lastly, we stratified each census tract into high/low occupational noise, chemical pollutant, and disease/infection exposure to examine racial/ethnic health disparities to diabetes, asthma, and high blood pressure, respectively, as a consequence of occupational exposure inequities. Our results show that racial/ethnic minority communities, particularly those that are also low-income, experience a disproportionate burden of workplace exposures that may be contributing to racial/ethnic health disparities. When composite risk measures, such as SVI, are calculated using only information from the local residential neighborhood, they may systematically under-count occupational risks experienced by the most vulnerable communities. There is a need to consider the role of occupational justice on nationwide, racial/ethnic health disparities.

Association of Community-Level Social Vulnerability With Clinical Trial Discussion and Participation Among Cancer Survivors.

Community factors and structural barriers may contribute to disparities and underrepresentation in cancer clinical trials. We evaluate the influence of community-level social determinants of health, as measured by the Centers for Disease Control and Prevention Social Vulnerability Index (SVI), on disparities in cancer clinical trial discussion and participation. We performed a cross-sectional analysis of the 2021 Health Information National Trends Survey-SEER, a representative survey of cancer survivors sampled from three SEER registries. The primary outcomes included patient-reported clinical trial discussion and participation. The primary exposure was county-level SVI, linked to each survey respondent by ZIP code of residence and categorized into quintiles. Survey-weighted bivariate comparisons and multivariable logistic regression were performed to evaluate the association between SVI and clinical trial discussion and participation, adjusting for age, sex, race and ethnicity, education, income, and cancer stage. We identified 1,220 respondents residing in 153 counties with a median SVI of 0.41 (IQR, 0.27-0.62), representing a population of over 400,000 cancer survivors on weighted analysis. Of the cohort, 15.1% reported clinical trial discussion and 7.7% reported clinical trial participation. Patients who are most socially vulnerable (fifth quintile of SVI) had significantly lower odds of clinical trial discussion (odds ratio [OR], 0.36 [95% CI, 0.15 to 0.87]; P = .02) and clinical trial participation (OR, 0.15 [95% CI, 0.03 to 0.75]; P = .02) compared with patients who are least socially vulnerable (first quintile of SVI). These findings suggest interventions to identify socially vulnerable communities for expansion of clinical trial opportunities and infrastructure may be an impactful strategy toward improving diversity and representation in cancer clinical trials.

Digital disease management programme reduces chronic gastrointestinal symptoms among racially and socially vulnerable populations

ObjectiveConsiderable disparities exist in access to gastrointestinal (GI) care and digestive outcomes across gender, racial, and socioeconomic groups. We evaluated (1) whether adults with chronic GI symptoms from diverse demographic...

Gestational exposure to wildfire PM2.5 and its specific components and the risk of gestational hypertension and eclampsia in the southwestern United States

In the southwestern United States, the frequency of summer wildfires has elevated ambient PM2.5 concentrations and rates of adverse birth outcomes. Notably, hypertensive disorders in pregnancy (HDP) constitute a significant determinant associated with maternal mortality and adverse birth outcomes. Despite the accumulating body of evidence, scant research has delved into the correlation between chemical components of wildfire PM2.5 and the risk of HDP. Derived from data provided by the National Center for Health Statistics, singleton births from >2.68 million pregnant women were selected across 8 states (Arizona, AZ; California, CA, Idaho, ID, Montana, MT; Nevada, NV; Oregon, OR; Utah, UT, and Wyoming, WY) in the southwestern US from 2001 to 2004. A spatiotemporal model and a Goddard Earth Observing System chemical transport model were employed to forecast daily concentrations of total and wildfire PM2.5-derived exposure. Various modeling techniques including unadjusted analyses, covariate-adjusted models, propensity-score matching, and double robust typical logit models were applied to assess the relationship between wildfire PM2.5 exposure and gestational hypertension and eclampsia. Exposure to fire PM2.5, fire-sourced black carbon (BC) and organic carbon (OC) were associated with an augmented risk of gestational hypertension (ORPM2.5 = 1.125, 95 % CI: 1.109,1.141; ORBC = 1.247, 95 % CI: 1.214,1.281; OROC = 1.153, 95 % CI: 1.132, 1.174) and eclampsia (ORPM2.5 = 1.217, 95 % CI: 1.145,1.293; ORBC = 1.458, 95 % CI: 1.291,1.646; OROC = 1.309, 95 % CI: 1.208,1.418) during the pregnancy exposure window with the strongest effect. The associations were stronger that the observed effects of ambient PM2.5 in which the sources primarily came from urban emissions. Social vulnerability index (SVI), education years, pre-pregnancy diabetes, and hypertension acted as effect modifiers. Gestational exposure to wildfire PM2.5 and specific chemical components (BC and OC) increased gestational hypertension and eclampsia risk in the southwestern United States.

Estimating the Role of Uninsured in the Spread of COVID-19 via Geospatial Bayesian Models

In this article, we develop and use several geospatial models to estimate the effects of health insurance status and vaccination coverage in the spread of COVID-19. We focus on COVID-19 related mortality, infection, and fatality rates as health outcomes. Utilizing these existing methods an analysis is conducted at the national level using data for every county in the United States, then a case is formed with analyses where the counties are restricted to those within Texas and Mid USA, which includes Nebraska, Iowa, Missouri, and Kansas. The main goal of this study is to investigate how different factors, such as vaccination status, socioeconomic status including insurance, and geographic location, may have affected the geospatial spread of COVID-19 pandemic and related health outcomes. Results show that the percentage of the senior population, the vaccination rate and the uninsured percentage are the most important variables for predicting infection rates and the fatality rates, while the overall social vulnerability index has a huge impact on mortality rates and infection rates. Our analyses can shed light on the impact of health insurance status and inform policy makers regarding the importance of health insurance coverage.

Factors Associated With Potentially Unnecessary Transfers for Children With Asthma: A Retrospective Cohort Study.

Our objective was to identify the hospital- and community-related factors associated with the hospital-level rate of potentially unnecessary interfacility transfers (IFTs) for pediatric patients with asthma exacerbations. We analyzed California Emergency Department (ED) data from 2016 to 2019 to capture ED visits where a pediatric patient (age, 2-17 years) presented with an asthma exacerbation and was transferred to another ED or acute care hospital. The primary outcome was hospital-level rate of potentially unnecessary IFTs, defined as a visit where length of stay after transfer was <24 hours and no advanced services (eg, critical care) were used. Hospital- and community-related characteristics included urbanicity, teaching hospital status, availability of pediatric resources in the sending facility and patient's community, pediatric patient volume, and Social Vulnerability Index. We described and compared hospitals in the top quartile of potentially unnecessary IFT rate versus all others and used a multivariable modified Poisson model to identify factors associated with potentially unnecessary IFT. A total of 325 sending hospitals were included, with a median 573 pediatric asthma visits (interquartile range, 183-1309) per hospital annually. Nearly half of the hospitals (145/325, 45%) sent a potentially unnecessary IFT. Most (90%) hospitals were urban, 9% were teaching hospitals, 5% had >500 beds, and 22% had a pediatric ED on-site. Factors associated with higher adjusted prevalence of potentially unnecessary IFT included availability of pediatric telehealth (prevalence ratio [PR], 1.5; 95% confidence interval [CI], 1.2-2.0), increased pediatric volume (eg, <1800 vs ≥10,000 visits: PR, 2.6; 95% CI, 1.4-4.7), and higher community Social Vulnerability Index (PR, 1.5; 95% CI, 1.1-1.9). Several hospital- and community-related factors were associated with potentially unnecessary IFTs among pediatric patients presenting to the ED with asthma exacerbations. These findings provide insight into disparities in potentially unnecessary IFT across communities and can guide the development of future interventions.

Assessment of coastal vulnerability using AHP and machine learning techniques

Vila Belmiro is a significant development in the coastal urban scenario and is nestled along the rugged cliffs of the southern coast of Brazil. Cyclones caused tremendous damage to the shore, destroying infrastructure, eroding the coast, flooding, and displacing people. Determining such low-lying regions' coastal vulnerability index is crucial for developing efficient mitigation strategies and enhancing readiness for calamities. In light of this viewpoint, the current study attempted to determine the Coastal Vulnerability Index (CVI) using the analytical hierarchical process (AHP). The study combined the Physical Vulnerability Index (PVI) and the Social Vulnerability Index (SVI) to create the Coastal Vulnerability Index. This study generated the LULC layer for Vila Belmiro using machine learning techniques and Random Forest based model. A component of the process was evaluating the parameters pairwise based on their importance and relevance to the study's objective. The CVI assessment classified 19.28 Sq.km of the coastline, including Solemar, São Vicente, Santo, and Ponta Da Praia, as very high risk. High-risk areas, such as São Vicente, Vila Caicara, and Guaruja, span 25.26 Sq.km. Medium risk was observed across 16.85 Sq.km, covering Praia Grande, Nova Mirim, and Balneario Praia. Low-risk regions, including Japui and Jarfim Guaiuba, extend over 13.54 Sq.km. Lastly, 10.78 Sq.km of the coastline, including Canto Do Forte, were classified as very low risk. These measurements highlight the varying levels of vulnerability along the coastline. The study concluded that coastal vulnerability zones were effectively identified and assessed, enhancing understanding and management of coastal risks. Planning and mitigating future cyclones can benefit from the identified vulnerable zones. The current study included machine learning, remote sensing, Geographic Information System (GIS), and advanced facilities that were spatially integrated with AHP approaches.

Relationship between social vulnerability and community resilience: A geospatial study in the context of natural disasters

Social vulnerability and resilience are critical factors for disaster risk management. Despite the significant progress in research on both concepts, only some studies have explored the empirical relationship between them. The relationship between community resilience and social vulnerability to natural disasters in Chile was studied using empirical and geospatial analysis. We used the Social Vulnerability Index (SoVI) and the Community Resilience Index (BRIC), previously calculated nationally for Chile. Based on these indicators, we constructed a matrix to classify the 3100 districts into high, medium, and low levels of vulnerability and resilience. In addition, we performed a spatial autocorrelation analysis using the Global Moran Index. Our results indicate that: Vulnerability and resilience are related concepts, but are not opposite within a continuum, (II) Rather than being randomly distributed, districts with higher (or lower) capacities to prepare for, respond to, and recover from a disaster tend to cluster geographically; (III) the districts with the highest levels of resilience and lowest levels of vulnerability were located in the main cities of the country. We expect that a better understanding of the relationship between vulnerability and resilience in each territory will help institutions in charge of disaster management to identify communities most susceptible to damage and least capable of recovering from a disaster. Consequently, it will facilitate the design and implementation of policies, programs, and plans best adapted to the needs of each community.

Social vulnerability and prenatal diagnosis.

There are limited data on how neighborhood-level risk factors affect the likelihood of having prenatal diagnosis. Neighborhood social vulnerability can be quantified and ranked using the social vulnerability index (SVI), a tool that measures the cumulative effect of external stressors in the local environment that may affect health outcomes. The objective of the study was to determine the relationship between SVI and prenatal diagnosis among pregnant patients who received genetic counseling. Retrospective cohort study of all pregnant patients who had genetic counseling at two hospitals in New York between January 2019 and December 2022. For each patient, the address of residence was linked to an SVI score (primary exposure) based on census tract. SVI scores were subdivided into fifths and analyzed categorically. The primary outcome was prenatal diagnosis (yes/no). Multivariable logistic regression was performed. A total of 5,935 patients were included for analysis and 231 (3.9 %) had prenatal diagnosis. On regression analysis, no association between SVI and prenatal diagnosis wasobserved. Patients who had a diagnostic procedure weremore likely to be English speaking (aOR 1.80; 95 % CI 1.13-2.87), carriers of a genetic disorder (aOR 1.94; 95 % CI 1.32-2.86), had increased NT (aOR 6.89; 95 % CI 3.65-13.00), abnormal NIPS (aOR 9.58; 95 % CI 5.81-15.80), or had fetal structural anomalies (aOR 10.60; 95 % CI 6.62-16.96). No differences were seen based on race and ethnicity group, insurance type, or marital status. SVI score does not affect rate of prenatal diagnosis. Findings may differ in other geographic regions and populations.

Mapping pharmacy deserts in North Carolina: a geospatial analysis and its implications for University of North Carolina Health’s catchment population

BackgroundPharmacy deserts represent areas where residents face notable challenges to accessing pharmacies. North Carolina (NC) presents an intriguing case study due to its diverse geographic landscape yet lacks extensive research regarding its pharmacy deserts. ObjectivesThis study aims to map pharmacy deserts in NC using pharmacy location and social determinants of health (SDOH) data measured using the social vulnerability index (SVI) and descriptively characterize health care utilization statistics for University of North Carolina (UNC) Health’s catchment population. MethodsPharmacy location data was compiled from the NC Board of Pharmacy. Pharmacy deserts were defined based on SVI > 0.75 and distance thresholds aligned to United States Department of Agriculture standards. Residential characteristics were retrieved from PolicyMap and Social Explorer databases. UNC Health patient utilization data were collected by UNC Pharmacy Data Analytics group for 3 NC counties. ResultsTwo thousand and two NC pharmacies met inclusion criteria. 17.2% urban tracts (1.3M residents) and 4.25% rural tracts (0.14M residents) were identified as pharmacy deserts (adj. P < 0.001). Those residing in deserts had significantly less internet access, annual medical cost per capita, and access to homeless relief services as well as significantly higher food insecurity rates and Medicare cost per capita (adj. P < 0.001). UNC-specific health care utilization statistics for the 3 assessed counties were all poorer in deserts compared to nondeserts within the same counties (P > 0.05). ConclusionA geospatial map with the location of pharmacy deserts in NC was created to highlight differences in patient health care utilization, affecting rural and urban areas. By incorporating SDOH predictors, this study provides a more nuanced map of NC pharmacy deserts compared to reviewing distance to pharmacies alone. Higher rates of emergency department and inpatient visits in counties with more residents in pharmacy deserts suggests potential health outcomes associated with limited pharmacy access.

Non-Linkage to Care and Non-Viral Suppression among Hispanic/Latino Persons by Birthplace and Social Vulnerability-United States, 2021.

Assessing individual- and community-level factors may help to explain differences among Hispanic/Latino adults with diagnosed HIV not linked to care and without viral suppression in the United States. We analyzed CDC's National HIV Surveillance System data among Hispanic/Latino persons aged ≥ 18years with HIV diagnosed during 2021 in 47 states and the District of Columbia and linked cases via census tracts to the CDC/ATSDR's Social Vulnerability Index (SVI). Adjusted prevalence ratios and 95% confidence intervals for non-linkage to care and non-viral suppression were estimated using Poisson regression model. Among 5,056 Hispanic/Latino adults with HIV diagnosed in 2021, 51.5% were born in the United States, 17.3% in Mexico, 9.2% in Central America, 11.1% in South America, 1.8% in Puerto Rico, 6.8% in Cuba, and 2.4% in the Caribbean. Compared with U.S.-born Hispanic/Latino adults, those born in Mexico and South America had a lower prevalence of non-linkage to care. Hispanic/Latino adults born in Mexico, South America, and the Caribbean (excluding Puerto Rico and Cuba) had a lower prevalence of non-viral suppression, compared with those born in the United States. No significant differences were observed among SVI quartiles for either care outcome. This study aimed to challenge the narrow perspective on HIV care outcomes by examining the impact of birthplace and social vulnerability among Hispanic/Latino adults. To increase HIV care and prevention among Hispanic/Latino persons, research must evaluate health disparities within the group, and efforts are needed to better understand and tailor interventions within the diverse Hispanic/Latino population.

Exploring Stress and Coping in Caregivers of Children with Pulmonary Vein Stenosis: A Mixed-Method Study.

(1) Background: This mixed-method study aims to identify and describe factors associated with acute and long-term parenting stressors and coping strategies in caregivers of children with intraluminal pulmonary vein stenosis (PVS). (2) Methods: Parents of children with severe PVS were recruited from a large quaternary hospital to complete a survey that included demographics, the Pediatric Inventory for Parents (PIP), and the Coping Health Inventory for Parents (CHIP). We determined the Social Vulnerability Index (SVI) based on self-reported home address. A subset of caregivers completed a 60 min semi-structured interview via Zoom exploring the impact their child's diagnosis had on their family; experience managing stress in the hospital and at home; current resources and processes for coping; and potential recommendations for hospitals to build resilience and coping. We used multivariable linear regression to examine the association between SVI and parental stress and coping while adjusting for possible confounders. Thematic analysis identified themes related to stress and coping. Finally, we assessed instances of convergence and difference between the qualitative and quantitative results. (3) Results: Participants included 32 caregivers who were 91% female with a mean age of 39 years. The children of participants were 66% female, with a mean age of five years. The parents reported a high amount of stress with an average PIP score of 120, nearly 46 points higher than similar studies in the congenital heart community. We observed no significant associations between SVI and either parental stress or coping in adjusted models. We identified 13 themes, including medical care, hospital, family, support systems, and home medical routine or support. (4) Conclusions: Our study found high levels of illness-related parental stress among caregivers of children with PVS. Stress evolved over time from what caregivers described as 'survival mode' to a future-oriented outlook. Currently, caregivers rely heavily on support networks that are not available to all caregivers or may experience strain over time. Caregivers indicated that communication and parental role functioning were coping strategies that could be better supported by providers and health systems.

Social vulnerability and perioperative outcomes after colectomy for colon cancer

BackgroundThe Social Vulnerability Index (SVI) has previously been demonstrated to correlate with worse postoperative outcomes after surgery, but the association of SVI with short- and long-term outcomes after colon cancer surgery has been underexplored. MethodsThis is a retrospective cross-sectional study of Medicare patients aged 65 to 99 years who underwent colectomy for colon cancer between 2016 and 2020, merged with SVI at the census tract level. We tested the association between SVI with emergent colectomy and 30-day and 1-year mortality using a multivariable logistic regression model adjusted for patient demographics and hospital characteristics. ResultsThe cohort included 169,498 patients who underwent colectomy for colon cancer. Medicare patients living in areas in the highest quintile of social vulnerability were more likely to undergo unplanned colectomy for colon cancer than those in the lowest quintile (35.6% vs 28.9%; adjusted odds ratio [aOR], 1.36; 95% CI, 1.31–1.41; P < .001). Similarly, patients living in areas in the highest quintile of social vulnerability experienced higher risk-adjusted rates of 30-day mortality (3.4% vs 2.9%; aOR, 1.20; 95% CI, 1.12–1.29; P < .001) and 1-year mortality (10.8% vs 8.6%; aOR, 1.30; 95% CI, 1.22–1.37; P < .001) than patients living in the lowest quintile of social vulnerability. When evaluating the elective and unplanned cohorts separately, these differences persisted. ConclusionAmong Medicare patients undergoing colectomy for colon cancer, high social vulnerability was associated with an increased risk of unplanned operations and worse short- and long-term postoperative outcomes in both the emergent and elective settings. Providers should seek to mitigate disparate surgical outcomes by addressing structural inequities in social resources.

Comparing Social Disadvantage Indices in Pediatric Populations.

Place-based social disadvantage indices are increasingly used to promote health equity, but vary in design. We compared associations between 3 commonly used indices (Social Vulnerability Index [SVI], Area Deprivation Index [ADI], and Child Opportunity Index [COI]) and infant well-child check (WCC) attendance and adolescent obesity. We hypothesized that the COI would have the strongest association with child health outcomes. We conducted a cross-sectional analysis of 2014-2019 Duke University Health System electronic health record data. Eligible participants were ≤18 years old, had outpatient encounters during the study period, and resided in Durham County, North Carolina. We aggregated indices into deciles; higher deciles represented greater disadvantage. Multivariable logistic regression models quantified the association between each index and infant WCC attendance (ages 0-15 months) and adolescent obesity (11-17 years). There were 10 175 and 14 961 children in the WCC and obesity cohorts, respectively. All 3 indices were similarly associated with WCCs (SVI odds ratio [OR] 1.10, 95% confidence interval [CI] 1.08-1.12; ADI OR 1.10, 95% CI 1.08-1.12; COI OR 1.12, 95% CI 1.10-1.14) and obesity (SVI OR 1.06, 95% CI 1.04-1.07; ADI OR 1.08, 95% CI 1.06-1.10; COI OR 1.07, 95% CI 1.05-1.08). ORs indicate the increase in the outcome odds for every 1-decile index score increase. Higher disadvantage as defined by all 3 indices was similarly associated with adolescent obesity and decreased infant WCC attendance. The SVI, ADI, and COI may be equally suitable for pediatric research, but population and outcome characteristics should be considered when selecting an index.