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.
Secondary analysis of data from the artmouth tlas, asterfile, ational rovider dentifier data, mall rea ealth nsurance stimates, merican ommunity urvey, rea esource ile, and ehavioural isk actor urveillance ystem. Data were aggregated to rimary are ervice reas ().
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 Sources/Study Setting
Variables not available at the level were estimated at block level, then aggregated to level.
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.
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.
Data Collection/Extraction Methods