Application of the Social Vulnerability Index for Identifying Teen Pregnancy Intervention Need in the United States
Application of the Social Vulnerability Index for Identifying Teen Pregnancy Intervention Need in the United States
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DOI：
10.1007/s10995-019-02792-7
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发表时间：
2019-11-01
影响因子：
2.3
通讯作者：
Ickovics, Jeannette R.
中科院分区：
文献类型：
--
作者：
Yee, Chloe W.;Cunningham, Shayna D.;Ickovics, Jeannette R.
目标最初是为了评估应急准备情况而制定的，有证据表明，社会脆弱性指数 (SVI) 也可能有助于调查多层次的环境和社会对健康风险行为和结果的影响。这项生态研究探讨了 SVI 作为美国各县青少年怀孕率预测指标的应用，并确定了最需要社区干预的地区。方法 县级 SVI 和青少年出生率数据从疾病预防控制中心获得。回归分析旨在检验青少年出生率与社会脆弱性、地理区域以及影响该指数的四个主题之间的关联：社会经济地位、家庭构成、少数民族地位和住房。使用青少年出生率和四分位数 SVI 的点图来检查各县的空间分布。结果 SVI 四分位值每增加一次，每 1000 名 15-19 岁女性的生育率就会增加 11.5 次。在美国，较高的社会脆弱性在不同程度上与较高的青少年出生率显着相关，其中在中东部（beta = 62.56；SE = 6.28；p < 0.001）和中西部（beta = 66.75；SE = 5.33；p < 0.001）人口普查分区中观察到的影响最大。在指数主题中，社会经济地位（beta = 25.56；SE = 1.16；p < 0.001）、家庭构成（beta = 23.49；SE = 1.00；p < 0.001）和少数民族/语言地位（beta = 10.99；SE = 0.83；p < 0.001）与青少年出生呈正相关。没有观察到与住房/交通的关联。结论 SVI 提供了一种新颖的工具，用于识别最需要资源的高危人群，并指导全美各地基于社区的青少年怀孕干预措施。
Objectives Originally developed to assess emergency preparedness, evidence suggests the Social Vulnerability Index (SVI) may also be useful to investigate multilevel environmental and social influences on health risk behaviors and outcomes. This ecological study explores the application of the SVI as a predictor of teen pregnancy rates across counties in the United States (U.S.) and identifies areas with greatest need for community-based interventions. Methods County-level SVI and teen birth rate data were obtained from the Centers for Disease Control and Prevention. Regression analysis was conducted to examine associations between teen birth rates and social vulnerability, geographic region, and the four themes which compromise the index: socioeconomic status, household composition, minority status, and housing. Dot maps of teen birth rates and SVI by quartiles were used to examine spatial distribution across counties. Results Each increase in SVI quartile was associated with an additional 11.5 births per 1000 females ages 15-19. Higher social vulnerability was significantly associated with higher teen birth rates to varying degrees across the U.S., with largest effect sizes observed in East South Central (beta = 62.56; SE = 6.28; p < 0.001) and West South Central (beta = 66.75; SE = 5.33; p < 0.001) Census divisions. Among index themes, socioeconomic status (beta = 25.56; SE = 1.16; p < 0.001), household composition (beta = 23.49; SE = 1.00; p < 0.001), and minority/language status (beta = 10.99; SE = 0.83; p < 0.001) were positively associated with teen birth. No association was observed with housing/transportation. Conclusions The SVI offers a novel tool for identifying at-risk populations most in need of resources and guiding community-based teen pregnancy interventions across the U.S.