Neighborhood disadvantage and chronic disease management.
Ontology highlight
ABSTRACT: Objective
To assess the relationship between a composite measure of neighborhood disadvantage, the Area Deprivation Index (ADI), and control of blood pressure, diabetes, and cholesterol in the Medicare Advantage (MA) population.Data sources
Secondary analysis of 2013 Medicare Healthcare Effectiveness Data and Information Set, Medicare enrollment data, and a neighborhood disadvantage indicator.Study design
We tested the association of neighborhood disadvantage with intermediate health outcomes. Generalized estimating equations were used to adjust for geographic and individual factors including region, sex, race/ethnicity, dual eligibility, disability, and rurality.Data collection
Data were linked by ZIP+4, representing compact geographic areas that can be linked to Census block groups.Principal findings
Compared with enrollees residing in the least disadvantaged neighborhoods, enrollees in the most disadvantaged neighborhoods were 5 percentage points (P < 0.05) less likely to have controlled blood pressure, 6.9 percentage points (P < 0.05) less likely to have controlled diabetes, and 9.9 percentage points (P < 0.05) less likely to have controlled cholesterol. Adjustment attenuated this relationship, but the association remained.Conclusions
The ADI is a strong, independent predictor of diabetes and cholesterol control, a moderate predictor of blood pressure control, and could be used to track neighborhood-level disparities and to target disparities-focused interventions in the MA population.
SUBMITTER: Durfey SNM
PROVIDER: S-EPMC6341202 | biostudies-literature | 2019 Feb
REPOSITORIES: biostudies-literature
Publications
Neighborhood disadvantage and chronic disease management.
Durfey Shayla N M SNM Kind Amy J H AJH Buckingham William R WR DuGoff Eva H EH Trivedi Amal N AN
Health services research 20181123
<h4>Objective</h4>To assess the relationship between a composite measure of neighborhood disadvantage, the Area Deprivation Index (ADI), and control of blood pressure, diabetes, and cholesterol in the Medicare Advantage (MA) population.<h4>Data sources</h4>Secondary analysis of 2013 Medicare Healthcare Effectiveness Data and Information Set, Medicare enrollment data, and a neighborhood disadvantage indicator.<h4>Study design</h4>We tested the association of neighborhood disadvantage with interme ...[more]
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