Comparing socioeconomic deprivation and social vulnerability measures for health

What is it about?

Socioeconomic deprivation includes socioeconomic dimensions such as income, employment, education, and housing. Deprivation is associated with numerous negative health outcomes, including shorter lifespan. Several deprivation measures are available to heath and healthcare researchers, practitioners, and policymakers. They often use these measures to address health equity and inform interventions and policy decisions. The chosen deprivation measure, however, can affect results due to differences between how measures were developed. This study compared two frequently used deprivation measures: the Area Deprivation Index (ADI) and the Social Vulnerability Index (SVI). Using U.S. census tracts, we compared ADI and SVI scores for each tract's deprivation level. We found that ADI and SVI "agreed" (within 10%) for only 44% of tracts. ADI and SVI "disagreed" (>=60% difference) for 6% of tracts. Of those 6%, 1 in 5 tracts had both high and low ADI scores. This means that ADI assigned low deprivation scores to high deprivation areas. Findings and prior studies suggested that this issue occurred due to ADI’s misclassification of tracts with high housing costs and high deprivation. ADI and SVI are not interchangeable measures of socioeconomic deprivation at the tract level. Careful consideration is necessary when selecting an area-level socioeconomic deprivation measure that appropriately defines deprivation relative to the context in which it will be used. How deprivation is operationalized affects interpretation by researchers as well as public health practitioners and policymakers making decisions about resource allocation and working to address health equity.

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Photo by Towfiqu barbhuiya on Unsplash

Photo by Towfiqu barbhuiya on Unsplash

Why is it important?

Deprivation measure selection can affect health research, interventions, and policy and resource allocation decisions, with the potential to divert resources away from areas in need. Once measures and policies are established that determine how resources are distributed, future changes can be difficult to make. Therefore, understanding measure differences in detail and identifying the consequences of selection can enable adjustments so all populations benefit from resource allocation decisions and policies as intended.

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