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两种区域层面社会经济剥夺指数的比较:对公共卫生研究、实践和政策的启示。

Comparison of two area-level socioeconomic deprivation indices: Implications for public health research, practice, and policy.

机构信息

Institute for Healthcare Policy and Innovation, Health & Design Research Fellowship Program, University of Michigan, Ann Arbor, Michigan, United States of America.

Institute for Social Research, Social Environment and Health, Survey Research Center, University of Michigan, Ann Arbor, Michigan, United States of America.

出版信息

PLoS One. 2023 Oct 5;18(10):e0292281. doi: 10.1371/journal.pone.0292281. eCollection 2023.

Abstract

OBJECTIVES

To compare 2 frequently used area-level socioeconomic deprivation indices: the Area Deprivation Index (ADI) and the Social Vulnerability Index (SVI).

METHODS

Index agreement was assessed via pairwise correlations, decile score distribution and mean comparisons, and mapping. The 2019 ADI and 2018 SVI indices at the U.S. census tract-level were analyzed.

RESULTS

Index correlation was modest (R = 0.51). Less than half (44.4%) of all tracts had good index agreement (0-1 decile difference). Among the 6.3% of tracts with poor index agreement (≥6 decile difference), nearly 1 in 5 were classified by high SVI and low ADI scores. Index items driving poor agreement, such as high rents, mortgages, and home values in urban areas with characteristics indicative of socioeconomic deprivation, were also identified.

CONCLUSIONS

Differences in index dimensions and agreement indicated that 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.

摘要

目的

比较两种常用的区域社会经济剥夺指数:区域剥夺指数(ADI)和社会脆弱性指数(SVI)。

方法

通过两两相关、十分位得分分布和均值比较以及绘图评估指数的一致性。分析了美国普查区层面的 2019 年 ADI 和 2018 年 SVI 指数。

结果

指数相关性适中(R=0.51)。不到一半(44.4%)的普查区具有良好的指数一致性(0-1 十分位差异)。在指数一致性较差的(≥6 十分位差异)6.3%的普查区中,几乎有 1/5 被归类为 SVI 高而 ADI 得分低的地区。还确定了导致指数一致性较差的指数项目,例如城市地区的高租金、抵押贷款和房屋价值,这些地区具有社会经济剥夺的特征。

结论

指数维度和一致性的差异表明,ADI 和 SVI 不能在普查区层面互换作为社会经济剥夺的衡量标准。在选择适合特定使用背景的区域社会经济剥夺衡量标准时,需要仔细考虑。剥夺的实施方式会影响研究人员以及公共卫生从业人员和决策者对资源分配的决策和解决健康公平问题的解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5062/10553799/b7e3b2abde7d/pone.0292281.g001.jpg

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