Social Vulnerability Index and Its Association With Postpartum Care Attendance

Area of Science:

• Public Health
• Health Services Research
• Social Epidemiology

Background:

• Postpartum care is crucial for maternal and infant health.
• Social determinants of health can significantly impact healthcare access and utilization.
• The Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI) identifies communities with higher vulnerability.

Purpose of the Study:

• To investigate the association between the CDC Social Vulnerability Index (SVI) score and attendance at postpartum care appointments.
• To determine if higher social vulnerability correlates with lower rates of postpartum visit attendance.

Main Methods:

• Retrospective cohort study of patients delivering between January 2022 and February 2024 in a New York City health care system.
• Utilized geocoding to assign CDC SVI scores (overall and thematic) based on patient addresses.
• Analyzed in-person obstetric visit attendance within 12 weeks postpartum using logistic regression, adjusting for demographic, medical, and obstetric factors.

Main Results:

• Of 21,539 patients, 65.1% attended postpartum visits within 12 weeks.
• High SVI scores were significantly associated with lower odds of attending postpartum visits (adjusted OR 0.85).
• Associations were observed with SVI socioeconomic, household composition, and racial/ethnic minority themes, but not housing or transportation.

Conclusions:

• A high CDC SVI score is associated with a reduced likelihood of attending in-person postpartum care within 12 weeks.
• Findings underscore the impact of social vulnerability on postpartum healthcare engagement.
• Targeted interventions may be needed to improve postpartum care access for socially vulnerable populations.