Validity of Area-Based Social Risk Indices Used at Higher-Level Geographies and Clinic Locations

How do area-based social risk indices using higher-level geographies and clinic addresses compare with indices calculated using small area data?In this cohort study including nearly 3 million patients, indices calculated at the patient block group were poorly correlated with indices using county and 3-digit zip code tabulation area (ZCTA) data, and virtually uncorrelated with indices using clinic addresses. Associations with diseases were generally weaker using county and 3-digit ZCTA levels of aggregation and clinic addresses.These findings suggest researchers should prefer indices calculated at the patient block group or tract for exposures.

Corresponding Author: Nathaniel Hendrix, PharmD, PhD, Center for Professionalism and Value in Health Care, American Board of Family Medicine, 1016 16th St NW, Ste 800, Washington, DC 20036 (nhendrix@theabfm.org).

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