Does choice of neighborhood disadvantage index matter? An application with preterm birth disparities in North Carolina

Abstract

Epidemiologists often investigate the impacts of neighborhood disadvantage (ND) on health using indices created from publicly available data. However, it is not clear how choice of ND index impacts results. We (1) determined commonly used ND indices in recent epidemiological research and (2) investigated how choice of index impacts the magnitude of the racial disparity in preterm birth (PTB) by level of ND. We reviewed abstracts in epidemiology journals and conferences from 2020 to 2023 to determine commonly used ND indices and assigned them to birth records for singleton live births with no birth defects to non-Hispanic (NH) Black and NH White birthing parents in North Carolina, 2016–2018. Prevalence differences in PTB per 100 births were estimated using linear binomial regression comparing births from NH Black and NH White birthing parents, stratified by ND index quartile. The most used indices in perinatal-specific research were the Neighborhood Deprivation Index, racial and economic Index of Concentration at the Extremes, Social Vulnerability Index, and Area Deprivation Index. We observed no significant differences in the magnitude of the Black-White disparity in PTB by ND index. While there were no notable differences in estimates, interpretation of results should consider the intent of an index and its components.