ArticleInternational journal for equity in health2023
Development of an individual index of social vulnerability that predicts negative healthcare events: a proposed tool to address healthcare equity in primary care research and practice.
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Utility of the Social Vulnerability Index in Addressing Breast Cancer Disparities: A Meta-Analysis.Journal of surgical oncology · 2025Pooled it
- Social vulnerability indices for proactively identifying at-risk individuals in healthcare: a systematic review.European journal of public health · 2025Pooled it
- Social vulnerability shapes deep clinical phenotypes and brain health in aging and dementia across Latin America.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Factors associated with unmet healthcare needs in patients using Primary Care Access Points for unattached patients in Quebec (Canada).PloS one · 2026Article
- Community-based diabetes self-management and support program: addressing quality of life and social vulnerability.BMC public health · 2025Article
- Bridging inequity gaps in healthcare through tailored support: implementation perspectives of the Social Health Bridge-Building Programme.BMC health services research · 2025Article
- Profiling patterns of patient experiences of access and continuity at team-based primary healthcare clinics (Canada): a latent class analysis.International journal for equity in health · 2024Article
- Patients Living with Social Vulnerabilities Experience Reduced Access at Team-Based Primary Healthcare Clinics.Healthcare policy = Politiques de sante · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
purposeSocially disadvantaged patients may lack self-efficacy to navigate a complex health system making them vulnerable to healthcare inequity. We aimed to develop an Index of social vulnerability that predicts increased risk of negative healthcare events (e.g. emergency hospitalization), independent of chronic disease burden. The analysis illustrates the conceptual and practical steps leading to the development of a pragmatic Index of social vulnerability to limited healthcare self-efficacy.
methodsUsing data from a 3-year cohort of 2507 adult primary care patients in Québec (Canada), we applied two complementary structural equation modelling approaches-Partial Least Squares Path Modelling (PLS-PM) and Multiple indicators and Multiple Causes (MIMIC) modelling-to identify a minimal set of social characteristics that could be summed into an Index related to limited healthcare self-efficacy. We then used logistic regression to determine if the Index predicted: hospital emergency department use; hospital admissions; unmet need for care, and others. We privileged parsimony over explanatory capacity in our analytic decisions to make the Index pragmatic for epidemiologic and clinical use.
resultsThe Individual Social Vulnerability Index is the weighted sum of five indicators: two indicators of social support; educational achievement; financial status; limited language proficiency. The Index predicts increased likelihood of all negative healthcare outcomes except unmet need, with a clear threshold at Index ≥ 2. The effect is independent of chronic disease burden.
conclusionWhen social deficits outweigh social assets by two or more (Index ≥ 2), there is an increased risk of negative healthcare events beyond the risk attributable to poor health. The Index is a pragmatic tool to identify a minority of patients who will require additional support to receive equitable healthcare.
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