To determine which area‐based socioeconomic status () indicator is best suited to monitor health care disparities from a delivery system perspective.
142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011.
Cross‐sectional, comparing associations between area‐based indicators and patient outcomes.
Address data were geocoded to construct area‐based indicators at block group (), census tract (), and code () levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (s) were calculated to quantify disparities detected by area‐based indicators and compared to s from self‐reported educational attainment.
indicators had less missing data than or indicators ( < .0001). Area‐based indicators were strongly associated with self‐report educational attainment ( < .0001). ,, and indicators all detected expected gradients in health outcomes similarly. Single‐item, cut point defined indicators performed as well as multidimensional indices and quantile indicators.
Area‐based indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP‐level median household income or percent poverty, using cut points.
Data Sources/Study Setting