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A systematic review of geographic indices of disadvantage with implications for older adults.


ABSTRACT:

Background

Neighborhood-level socioeconomic disadvantage has wide-ranging impacts on health outcomes, particularly in older adults. Although indices of disadvantage are a widely used tool, research conducted to date has not codified a set of standard variables that should be included in these indices for the US. The objective of this study was to conduct a systematic review of literature describing the construction of geographic indices of neighborhood-level disadvantage and to summarize and distill the key variables included in these indices. We also sought to demonstrate the utility of these indices for understanding neighborhood-level disadvantage in older adults.

Methods

We conducted a systematic review of existing indices in the English-language literature.

Results

We identified 6,021 articles, of which 130 met final study inclusion criteria. Our review identified seven core domains that existed across the surveyed papers, including: income, education, housing, employment, neighborhood structure, demographic makeup and health. While not universally present, the most prevalent variables included in these indices were education and employment.

Conclusion

Identifying these seven core domains is a key finding of this review. These domains should be considered for inclusion in future neighborhood-level disadvantage indices with at least 5 domains recommended to improve the strength of the resulting index. Targeting specific domains offers a path forward towards the construction of a new US-specific index of neighborhood disadvantage with health policy applications. Such an index will be especially useful for characterizing the lifecourse impact of lived disadvantage in older adults.

SUBMITTER: Buckingham WR 

PROVIDER: S-EPMC8564893 | biostudies-literature |

REPOSITORIES: biostudies-literature

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