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Neighborhood Deprivation as a Measure of Social Need and Healthcare Utilization: A Review of the Literature

George, Lisa M. (2021) Neighborhood Deprivation as a Measure of Social Need and Healthcare Utilization: A Review of the Literature. Master Essay, University of Pittsburgh.

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Social and material deprivation at the individual level has a well-documented relationship with increased risk for poor health outcomes and use of high-cost healthcare services. Unmet social needs, such as reliable transportation, access to nutritious foods, safe and stable housing, ability to pay household utilities, and personal safety, can affect individuals’ overall health status. However, the greater context in which people live also can have a significant impact on both health and healthcare utilization. Neighborhood-level deprivation can affect the physical and emotional well-being independent of residents’ individual socioeconomic status and can perpetuate the health inequities that exist in the United States. Longstanding structural factors have contributed to these inequities, and they are manifested in the form of reduced access to preventive care and chronic disease management.
Given the intrinsic link between unmet social needs and poor health, efforts to identify methods for addressing these needs are of great public health significance. Social needs screening in the clinical setting is not widely performed despite the benefit that information on unmet needs could provide in developing a plan of care. One promising strategy to address health disparities and unmet social needs is the use of geographic-based indices to identify and address deprivation at the neighborhood level. Such measures have been used outside of the United States to allocate funding to healthcare facilities, inform community needs assessments, and guide health policy with the ultimate goal of addressing disparities in population health. To gain an understanding of the utility of deprivation indices as predictors of healthcare outcomes and healthcare utilization in the United States, a review of the literature was conducted. Twelve studies were identified that developed and used several different neighborhood-level deprivation scales to assess healthcare utilization, chronic disease management, and mortality. Results of this review showed that measures of deprivation at the neighborhood level were effective predictors of poor health outcomes in the populations and geographic areas studied, and this information could be a useful adjunct to patients’ health records. The strengths and limitations of these studies as well as recommendations for further research are provided in this analysis.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
George, Lisa M.lig58@pitt.edulig58@pitt.edu0000-0002-2480-7832
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHawk,
Committee MemberBui,
Date: 10 February 2021
Date Type: Completion
Submission Date: 16 November 2020
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 69
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: social deprivation, social determinants of health, social needs screening, deprivation index
Date Deposited: 10 Feb 2021 16:06
Last Modified: 10 Feb 2022 06:15

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