State-Level Social Vulnerability Index and Healthcare Access in Patients With Atherosclerotic Cardiovascular Disease (from the BRFSS Survey)

Area-Level Socioeconomic Disadvantage and Health Care Spending

“…Higher state-level SVI was also associated with individuals reporting the absence of a primary care clinician and an inability to see a doctor because of cost. This lack of access could drive future health care spending due to a lack of preventive care and diagnostic services, leading to greater risk of decompensated illness or advanced presentations of disease . Indeed, one study found that Medicare patients from the highest quintile of ADI had higher preventable spending but lower total spending compared with patients in the lowest quintile, which may indicate unmet needs for necessary health care among these patients …”

“…27 For 30-day spending after COVID-19 diagnosis, residence in the highest SVI quartile was associated with $3266 higher inpatient and outpatient spending. 37 Four studies focused on patient-borne spending via self-reported measures of financial toxicity or hardship 31,32 (ADI-based) or difficulties accessing health care due to cost 16,34 (SVI-based), with all finding a positive association between increasing area-level disadvantage and these patient-centered outcomes. In 4 studies, spending was a secondary outcome, whereas utilization or quality measures, such as length of stay, 35 postoperative complications, 22 30-day mortality, 24 and risk of emergent colon operation, 23 were primary outcomes.…”

Association of Hospice Agency Location and Neighborhood Socioeconomic Disadvantage in the U.S.

“…29 The SVI uses 16 attributes from the American Community Survey data to capture social vulnerability at the US census tract level, and groups them into 4 domains of area-level disadvantage themes: socioeconomic status, household characteristics, racial and ethnic minority status, and housing type and transportation. Although the SVI was initially developed to predict a population's needs in times of a public health disaster, this tool has increasingly been used to investigate social vulnerability linked to health access [30][31][32] and outcomes at the neighborhood level, including mortality. [33][34][35] Understanding the relationship of neighborhood social vulnerability or disadvantage and hospice agency availability nationwide may inform ongoing efforts to design more equitable hospice delivery systems.…”

Alcoholic cardiomyopathy mortality and social vulnerability index: A nationwide cross-sectional analysis

“…In the United States (US), communities that have been severely affected by social vulnerability are also characterized by higher densities of alcohol outlets, leading to higher levels of alcohol consumption [ 2 ]. The SVI has been shown to impact many aspects of the cardiovascular disease care continuum, including prevalence of cardiovascular disease (CVD) risk factors and prevalence, outcomes including morbidity and mortality, readmission rates, and access to healthcare [ [3] , [4] , [5] , [6] , [7] ].…”