The social vulnerability metric (SVM) as a new tool for public health.
Health Serv Res
; 58(4): 873-881, 2023 08.
Article
em En
| MEDLINE
| ID: mdl-36401593
ABSTRACT
OBJECTIVE:
To derive and validate a new ecological measure of the social determinants of health (SDoH), calculable at the zip code or county level. DATA SOURCES AND STUDYSETTING:
The most recent releases of secondary, publicly available data were collected from national U.S. health agencies as well as state and city public health departments. STUDYDESIGN:
The Social Vulnerability Metric (SVM) was constructed from U.S. zip-code level measures (2018) from survey data using multidimensional Item Response Theory and validated using outcomes including all-cause mortality (2016), COVID-19 vaccination (2021), and emergency department visits for asthma (2018). The SVM was also compared with the existing Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) to determine convergent validity and differential predictive validity. DATA COLLECTION/EXTRACTIONMETHODS:
The data were collected directly from published files available to the public online from national U.S. health agencies as well as state and city public health departments. PRINCIPALFINDINGS:
The correlation between SVM scores and national age-adjusted county all-cause mortality was r = 0.68. This correlation demonstrated the SVM's robust validity and outperformed the SVI with an almost four-fold increase in explained variance (46% vs. 12%). The SVM was also highly correlated (r ≥ 0.60) to zip-code level health outcomes for the state of California and city of Chicago.CONCLUSIONS:
The SVM offers a measurement tool improving upon the performance of existing SDoH composite measures and has broad applicability to public health that may help in directing future policies and interventions. The SVM provides a single measure of SDoH that better quantifies associations with health outcomes.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
COVID-19
/
Vulnerabilidade Social
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
Health Serv Res
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos