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Assessment of Child Anthropometry in a Large Epidemiologic Study
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Comparing Social Disadvantage Indices in Pediatric Populations.

Anna Zolotor1, Ro W Huang1,2, Nrupen A Bhavsar3,4

  • 1Duke-Margolis Institute for Health Policy, Washington, District of Columbia.

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|August 15, 2024
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Summary

Three place-based social disadvantage indices showed similar associations with infant well-child check attendance and adolescent obesity. The Social Vulnerability Index (SVI), Area Deprivation Index (ADI), and Child Opportunity Index (COI) may be suitable for pediatric health equity research.

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Area of Science:

  • Pediatric Health
  • Health Equity Research
  • Social Determinants of Health

Background:

  • Place-based social disadvantage indices are vital tools for advancing health equity.
  • Existing indices, such as the Social Vulnerability Index (SVI), Area Deprivation Index (ADI), and Child Opportunity Index (COI), vary in their construction and application.
  • Understanding the comparative effectiveness of these indices in relation to child health outcomes is crucial for their optimal utilization.

Purpose of the Study:

  • To compare the associations between three commonly used social disadvantage indices (SVI, ADI, COI) and key child health indicators.
  • To evaluate the relationship between these indices and infant well-child check (WCC) attendance.
  • To assess the link between these indices and adolescent obesity rates.

Main Methods:

  • A cross-sectional analysis was performed using electronic health record data from Duke University Health System (2014-2019).
  • Data included children aged ≤18 years residing in Durham County, North Carolina.
  • Multivariable logistic regression models were employed to analyze the association between index deciles and infant WCC attendance and adolescent obesity.

Main Results:

  • All three indices demonstrated similar associations with infant WCC attendance and adolescent obesity.
  • Higher deciles of SVI, ADI, and COI were associated with decreased WCC attendance and increased odds of adolescent obesity.
  • Odds ratios indicated a consistent pattern of association across the indices for both outcomes.

Conclusions:

  • The Social Vulnerability Index (SVI), Area Deprivation Index (ADI), and Child Opportunity Index (COI) exhibited comparable associations with infant well-child check attendance and adolescent obesity.
  • These findings suggest that SVI, ADI, and COI may be similarly appropriate for use in pediatric health equity research.
  • The selection of a specific index should be guided by the characteristics of the population and the specific health outcomes under investigation.