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Relationship Between Socioeconomic Deprivation and Healthy Days

Published in Population Health Management on January 31, 2025
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Study motivation

Population Health research has long demonstrated that where someone lives is highly correlated with health outcomes and quality of life. This study explored if this relationship remained between zip code socioeconomic deprivation index (SDI) and member-reported healthy days among commercially-insured adults interacting with virtual care and navigation services offered by Included Health.

Methodology

  • Members interacting with Included Health’s virtual care and navigation services between May 1, 2023 and May 31, 2024 received an SMS-based survey that included the four Centers for Disease Control and Prevention (CDC) Healthy Days questions after interacting with the digital health application. 
  • The proportion of members who reported frequent (14 or more) physically unhealthy, mentally unhealthy, and total unhealthy days during the past 30 days were calculated. 
  • The adjusted odds ratio for reporting frequent total unhealthy days was estimated by members’ zip code SDI quartile, accounting for member demographic characteristics. 

What we found

  • Of the 6,692 survey respondents, 13.7% reported frequent physically unhealthy days, 20.8% reported frequent mentally unhealthy days, and 29.2% reported frequent total unhealthy days. 
  • After adjusting for covariates, members in the highest SDI quartile were 1.21 times more likely to report frequent unhealthy days (p=0.047) than those in the lowest SDI quartile.

Implications

The results demonstrate the importance of geographic indices, in the absence of other data, to assist employers in identifying members with potentially higher need of digital health services. It also highlights the feasibility of collection quality of life measures to identify members who could benefit from timely intervention.

Marshall J, Bright OJ, Leiby N, Thames T, Yurkovic A. Relationship Between Socioeconomic Deprivation and Healthy Days Among Commercially Insured Adults Using a Digital Health Application: An Observational Study. Population Health management. 2025. Jan 31. doi: 10.1089/pop.2024.0202. Epub ahead of print. PMID: 39887064.