U-M study examines how to best allocate health resources to socioeconomically deprived communities

A recent University of Michigan study examined measures of socioeconomic deprivation to determine how best to allocate public health resources to communities.
 
According to Dr. Kimberly Rollings, who led the study, socioeconomic deprivation refers to factors like income, employment, education, and housing, which can be measured to determine which populations or geographic areas are most in need of additional support.
 
"Measuring area-level deprivation is important to understand and address inequalities at a community level," Rollings says via email.
 
Researchers currently use two different measures to evaluate deprivation: the Area Deprivation Index (ADI) and the Social Vulnerability Index (SVI).
 
According to Rollings, both ADI and SVI "have strengths and limitations," but are frequently used interchangeably when, in fact, they have different purposes.
 
While ADI examines deprivation at the neighborhood or block level, SVI was developed to identify populations most vulnerable to natural disaster or disease outbreak, such as COVID-19. In other words, while ADI quantifies deprivation, SVI examines vulnerability.
 
"Based on our research and other recent publications, a statistical error was identified in the ADI, specifically," Rollings says.
 
One of the factors that ADI takes into account is the cost of housing.
 
"Because average home prices vary across the U.S., those values must be adjusted or 'normalized' when comparing them," Rollings says. "Otherwise, areas that have both high poverty and high housing costs may be considered to have 'low deprivation' when deprivation is actually high."
 
The larger point, Rollings says, is that the measure or index researchers choose to analyze communities is not only important, but it can also have a major impact on whether those communities wind up receiving public resources.
 
If a community is incorrectly labeled "low deprivation," it may not receive resources that are in fact sorely needed.
 
Rollings says researchers "must very carefully consider the context … in which an index will be used to avoid potentially diverting resources away from areas in need."

Natalia Holtzman is a freelance writer based in Ann Arbor. Her work has appeared in publications such as the Minneapolis Star Tribune, the Los Angeles Review of Books, Literary Hub, The Millions, and others.

Graphic courtesy of Dr. Kimberly Rollings.
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