A Comparative Assessment of Measures of Area-Level Socio-Economic Status (WP-23-43)
Lorenzo Franchi, Natalia Barreto Parra, Anna Chorniy, Benjamin Weston, John Meurer, Jeffrey Whittle, Ronald Ackermann, and Bernard Black
This article provides a comparative assessment of three commonly used measures of area-level socio-economic status: Graham Social Deprivation Index (SDI), Neighborhood Atlas Area Deprivation Index (ADI), CDC Social Vulnerability Index (SVI). The researchers assess the indices’ ability to predict a variety of health outcomes and compare them to two simpler measures, the Townsend Deprivation Index (TDI) and population percent in poverty (Poverty), at the county, zip-code, Census-tract, and Census-block-group levels. The researchers do not know how hypothetical true area-SES would predict these outcomes. However, all measures appear valid, at zip-code, tract, and block-group levels, in that they predict health outcomes, controlling for age, gender, race/ethnicity, and comorbidities. Predictive power is comparable for SDI, SVI, and a standardized version of ADI, and superior to TDI, Poverty, or non-standardized ADI. Their preferred geographic level is Census tract if data are available, but zip-code is a reasonable substitute.