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Integrating Social Determinants of Health With Treatment and Prevention: A New Tool to Assess Local Area Deprivation


This figure contains 2 maps, each depicting 8 counties in the Hudson Valley, New York. The first map shows the zip code tabulation area (ZCTA) area deprivation index (ADI) values dichotomized (top 15% and bottom 85%) based on regional values. The overall trend is that ZCTAs in the northwestern portion of the study area, mostly in Sullivan and Delaware counties, have a high level of deprivation. The second map shows the same study area, but uses the dichotomized ADI values based on local 10-km calibration. The results illustrate ZCTAs with high levels of deprivation are more evenly dispersed throughout the study area.

Figure 1. Regional versus local variation in the area deprivation index (ADI) in the Hudson Valley of New York. Dichotomized ADI values were calibrated on the basis of regional and local 10-km scales by zip code tabulation area.

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This choropleth map shows 8 counties in the Hudson Valley, New York. The total hospitalization rate is shown by zip code tabulation area (ZCTA). There are 4 classes based on quartiles in the choropleth map. The lowest class represents fewer than 62 hospitalizations per 1,000 residents, the second, third, and fourth classes represent 62 to 79, 80 to 108, and 108 or more hospitalizations per 1,000 residents, respectively. ZCTAs that were flagged as having a high-level deprivation using the local 10-km calibration demonstrate the spatial coincidence of high local levels of deprivation and total hospitalization rates.

Figure 2. Local area deprivation index (ADI) values versus total hospitalization rate, Hudson Valley, New York. Zip code tabulation areas are indicated with cross hatching to depict local 10-km ADI values above the 15% threshold. Total hospitalization rates (1999–2000) are shown in quartiles. Maps of other health outcomes are available from the author upon request.

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Page last reviewed: September 15, 2016