Socioeconomic Distress as a Predictor of Missed First Outpatient Newborn Visits

Abstract

To determine if the Area Deprivation Index (ADI) can serve as a predictor for patients from geographic regions of high socioeconomic distress as high risk for having no-shows to first-year newborn visits. MethodsWe assessed the no-show rate per patient from a large public safety-net hospital in Cleveland, Ohio, and the ADI of the census-designated tract for each patient's home geographic identifier (GEOID), aggregated into quintiles, and calculated differences in no-show-rates across census-designated tracts of different ADIs. ResultsA total of 2944 newborns from an approximate 18-month follow-up period between 2015-2017 were included. Large differences in no-shows per individual patient record (chi-square = 225, p = <0.001, df = 4) were found across quintiles of ADI. Heat-mapping indicated that census tracts with the highest ADIs and highest rates of no-show appointments encompass Cleveland's inner-city region. ConclusionThe ADI is demonstrated to identify communities at high risk of no-show newborn appointments. Mapping these communities and their socioeconomic distress levels represented by ADI and missed appointment rate for each community can provide future direction for interventions targeted towards these communities to reduce no-show rates and improve overall community infant health.

Neighborhood and racial influences on triple negative breast cancer: evidence from Northeast Ohio

“…Additionally, prominent medical professional organizations and publications have recently issued directives guiding scientists and authors to (1) more carefully denote the reason and basis of measuring variables that classify individuals (including race and ethnicity and socioeconomic position) and (2) to rigorously evaluate the contributions of these social indicators to health and disease incidence and outcomes. [22,23] Research has clearly established the notable and often substantial in uence of neighborhood socioeconomic circumstances (such as the area deprivation index or ADI) on disease incidence [24], care patterns [25][26][27][28][29] and outcomes across many health conditions [30][31][32], including multiple cancer types [33][34][35], even while accounting for individual characteristics and behaviors, and various person, context, and population factors are understood to converge to produce different outcomes along the cancer care continuum (Fig. 1).…”