Is a Patient's Current Address of Record a Reasonable Measure of Neighborhood Deprivation Exposure? A Case for the Use of Point in Time Measures of Residence in Clinical Care

Bibliographic Data

ID19578096
AuthorsAndrew J Knighton (0000-0002-8276-0454, Intermountain Healthcare, corresponding author)
Year2018
Volume2
Issue1
Pages62-69
Publication date2018-06-01
Open AccessYes
TypeARTICLE
VenueHealth Equity (JOURNAL)
Journal identifiersISSN: 2473-1242 • E-ISSN: 2473-1242
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1089/heq.2017.0005
PMID30283850
OpenAlexW2801249728
LanguageEN
Citations received2
References cited30

Purpose: Interest is increasing in the use of geocoded patient address data to understand the effects that social determinants of health have on healthcare outcomes. Use of a patient's current address of record is often problematic given population mobility. Intragenerational economic mobility research suggests that patients will reside within neighborhoods with similar relative deprivation over time despite geographic mobility. The purpose of this study was to measure evidence of patient neighborhood deprivation persistence given a change in address of record. Methods: A retrospective cohort study of patients receiving active care in an integrated delivery system in a high-mobility United States region. Neighborhood deprivation was measured using a block-group level area deprivation index. Neighborhood deprivation persistence was measured as the probability that an individual with an address of record change remained within a neighborhood with a similar deprivation score. Logistic regression was used to conduct multivariate analysis. Results: Geographic mobility was highest among patients living in the most deprived neighborhoods versus least-deprived (odds ratio 1.75; 95% confidence interval: 1.71–1.79). Seventy-eight percent of all patients with a change of address did so to a neighborhood with a similar deprivation quintile. The probability that a random patient selected from the study had a change of address outside the same or neighboring quintile within a 1-year period ranged from 2% to 13%. Conclusions: Neighborhood deprivation persistence was high among this population of patients from a high mobility region. A current address of record is a reasonable indicator of patient exposure to neighborhood deprivation within a 1–3-year timeframe that is useful in evaluating healthcare disparities

Confidence interval · Environmental health · Logistic regression · Odds · Odds ratio · Population · Residence · Social deprivation · Demography · Employment and Welfare Studies · Health disparities and outcomes · Medicine · Urban, Neighborhood, and Segregation Studies · Gerontology