Rural-urban comparisons of area-based socioeconomic disadvantage and vulnerability indices

Clicks: 1
ID: 320347
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #71 of 89 articles by views in Health Affairs Scholar

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Policymakers and health systems increasingly rely on area-based socioeconomic disadvantage indices to inform health policy and resource allocation. However, the extent to which indices score the same areas differently across the rural-urban continuum remains poorly understood. Methods We compared five nationwide U.S. indices (2022 versions) at the census tract-level across four rural-urban designations using correlations, reliability testing, and decile score distributions. For the most discordant pair, the Neighborhood Atlas Area Deprivation Index (NA-ADI) and the Social Vulnerability Index (SVI), we used ridge regression and dominance analysis to identify specific items driving index disagreement. Results Disadvantage indices are not interchangeable. NA-ADI’s unstandardized items demonstrated rural-urban and demographic biases. In metropolitan areas, NA-ADI’s over-weighted housing cost and income items masked vulnerability among housing cost-burdened, predominantly urban minority populations, classifying these tracts as low deprivation. Conversely, in non-urban areas, NA-ADI inflated deprivation scores in predominantly white tracts with relatively lower proportions of disadvantage indicators due to inherently lower housing costs. Conclusion NA-ADI’s lack of item standardization risks exacerbating disparities that disadvantage indices aim to alleviate. Transitioning to more methodologically rigorous, transparent indices and developing context-specific rural metrics are urgent imperatives for effective, efficient resource allocation and to address health disparities.
Reference Key
openalex_W7167783466 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Hannah Lang, Kimberly A. Rollings
Journal Health Affairs Scholar
Year 2026
DOI
10.1093/haschl/qxag173
URL
https://doi.org/10.1093/haschl/qxag173
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.