Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery
Open accessAbstract
Objective: To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. Data Sources/Study Setting: Secondary analysis of data from the D artmouth A tlas, AMA M asterfile, N ational P rovider I dentifier data, S mall A rea H ealth I nsurance E stimates, A merican C ommunity S urvey, A rea R esource F ile, and B ehavioural R isk F actor S urveillance S ystem. Data were aggregated to p rimary c are s ervice a reas ( PCSAs ). Study Design: Social deprivation variables were selected from literature review and international examples. Factor analysis was used. Correlation and multivariate analyses were conducted between index, health outcomes, and measures of health care access. The derived index was compared with poverty as a predictor of health outcomes. Data Collection/Extraction Methods: Variables not available at the PCSA level were estimated at block level, then aggregated to PCSA level. Principal Findings: Our social deprivation index is positively associated with poor access and poor health outcomes. This pattern holds in multivariate analyses controlling for other measures of access. A multidimensional measure of deprivation is more strongly associated with health outcomes than a measure of poverty alone. Conclusions: This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35‐year‐old provider shortage and geographic underservice designation criteria used to allocate federal resources.
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Communities with poor housing, transportation, poverty, and education have higher rates of diabetes.
“communities with poor housing, transportation, poverty, and education have higher rates of diabetes [23-25].”
From An Assessment of How Clinicians and Staff Members Use a Diabetes Artificial Intelligence Prediction Tool: Mixed Methods Study (2023) · cites this paper as [24]
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Self-citation
- Authors
- Butler, D. C., Petterson, S., Phillips, R. L., & Bazemore, A. W.
- Affiliations
- Australian National University (AU)
- American Academy of Family Physicians (US)
- Corresponding author
- Butler, Danielle C.
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2012-07-20
- Volume
- 48
- Issue
- 2pt1
- Pages
- 539-559
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC3626349
- OpenAlex
- W2077385536
- Cited by
- 689
- References
- 27
- Citations by year
- 2026: 91 · 2025: 142 · 2024: 124 · 2023: 107 · 2022: 84 · 2021: 50 · 2020: 29 · 2019: 16 · 2018: 13 · 2017: 3 · 2016: 14 · 2015: 6 · 2014: 5 · 2013: 5
- FWCI
- 5.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Services Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Keywords
- social deprivation, social deprivation index, health care access, health outcomes, geographic variation in health care, poverty, healthcare resource allocation
- MeSH terms
- Diabetes Mellitus, Health Services Accessibility, Humans, Infant Mortality, Infant, Low Birth Weight, Infant, Newborn, Mortality, Primary Health Care, Socioeconomic Factors, Needs Assessment, Vulnerable Populations
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