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Comparing Predictive Power of Area-Level Socioeconomic Status Indices Across Health Outcomes and Geographic Levels
Francesco Maria Rossi1, Lorenzo Franchi2, Natalia Barreto3
1Northwestern University, Pritzker School of Law, Chicago, IL.
Medical Care
|December 23, 2025
Summary
The Graham Social Deprivation Index (SDI), Social Vulnerability Index (SVI), and standardized Area Deprivation Index (ADI) effectively predict health outcomes at census tract levels. These indices offer comparable predictive power, with SDI being more parsimonious.
Area of Science:
- Public Health
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Researchers often need to control for individual and area-level socioeconomic status (SES) when studying health outcomes.
- Comparative assessments of area-SES indices across different geographic levels and health outcomes are limited.
Purpose of the Study:
- To compare the predictive power of three common area-SES indices: Graham Social Deprivation Index (SDI), Area Deprivation Index (ADI), and CDC Social Vulnerability Index (SVI).
- To evaluate these indices across various health outcomes and geographic levels (county, zip code, census tract, census block group).
- To compare SDI, ADI, and SVI against the Townsend Deprivation Index (TDI) and area poverty (area-Poverty).
Main Methods:
- Logistic and ordinary least squares regression analyses were employed.
- Data included Medicare fee-for-service beneficiaries, COVID-19 decedents, and drug overdose decedents.
- Area-SES indices (SDI, SVI, ADI, TDI, area-Poverty) were used as measures.
Main Results:
- All assessed area-SES measures demonstrated predictive capability for health outcomes across zip code, tract, and block-group levels, after controlling for demographic and health variables.
- The SDI, SVI, and a standardized ADI exhibited comparable and generally superior predictive power compared to TDI, area-Poverty, and non-standardized ADI.
- Predictive power was highest at the census tract level, followed by block group and zip code, with the weakest performance observed at the county level.
Conclusions:
- The SDI, SVI, and standardized ADI demonstrate similar predictive power for a range of health outcomes, with the census tract level being optimal for measurement.
- The SDI offers a more parsimonious option with comparable performance to SVI and standardized ADI.
- The non-standardized ADI is not recommended due to its lower predictive utility.
Keywords:
Graham social deprivation indexSES measuresTownsend deprivation indexarea deprivation indexpercent in povertysocial vulnerability indexsocioeconomic statusMore Related Videos
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