This document discusses the development and use of an area deprivation index (ADI) to measure socioeconomic status for patients based on their census block group. The ADI was developed by Singh in 2003 using 17 census measures of education, employment, income, and living conditions. For Utah, it assigns each census block group an ADI score using Singh's coefficients calculated from 2000 census data. Higher ADI scores indicate more deprivation. The Utah ADI has been used by Intermountain Healthcare to assess community health needs, identify high-risk patients, and study the impact of deprivation on conditions like hypertension. However, it has limitations since it uses area-level data as a proxy for individual characteristics.

1. Calculation of a Surrogate Measure of
Deprivation for use with Patient Centered Care
Delivery
Brad Stephenson
Andrew J Knighton PhD CPA
Lucy Savitz PhD MBA
Tom Belnap MS
Jim Vanderslice PhD

2. What is the Singh area deprivation index (ADI)?
• Index developed and validated by Singh
(2003) based upon 17 census measures
– Education
– Employment
– Income
– Living Conditions
• Developed at the census block group level
for the state of Utah (Knighton, 2015)
• Patient assigned an ADI score based upon
the census block group they live in
• Surrogate measure for impact of
deprivation/social determinants

3. Creating the ADI score for a Utah block group
• Used Singh Coefficients
for the 2000 census per
UW- Madison
• Raw score = individual
census measure*Singh
coefficient
• Total raw score =
∑(individual census
measure*coefficient)
• Standardized with mean
100 and SD 20
• Quintiles
3

4. Utah ADI results
Least Deprived Most Deprived
1 2 3 4 5

5. Profiling disparities by quintile
5
Knighton, 2015

6. Application
• Projects utilizing the ADI are being conducted at Intermountain:
– Development of a Community Health Needs Assessment
– Identification of high-risk patients for care management interventions.
– Assessing the impact of deprivation on treatment of patients with hypertension.
• Limitations
–Ecological Fallacy: Using area-level data as a proxy for individual characteristics

7. Questions?

8. References
Singh, GK. Area deprivation and widening inequalities in US mortality, 1969-
1998. Am J Public Health. 2003; 93; 1137-1143.
Knighton AJ, Savitz L, Belnap T, Stephenson B, VanDerslice JA. Introduction of an
area deprivation index measuring patient socio-economic status in an
integrated health system: implications for population health. 2015
(Unpublished).