Measures of Neighborhood Opportunity and Adherence to Recommended Pediatric Primary Care
Authors' conclusion
This cross-sectional study of electronic health record data found that neighborhood opportunity was associated with multiple pediatric primary care outcomes. Understanding these associations can help health systems identify neighborhoods that need additional support and advocate for and develop partnerships with community groups to promote child well-being. The findings underscore the importance of improving access to preventive care in low COI communities.
Study context
- Population
- Patients aged 0 to 19 years active in a large pediatric primary care network in the northeastern US, November 2020–November 2022; mean (SD) age 9.8 (5.9) years, 48.8% female, 46.7% non-Hispanic White, 61.9% commercially insured
- Participants
- 338,277 patients
- Exposure
- Very high vs very low Childhood Opportunity Index neighborhoods
- Very high Childhood Opportunity Index (COI)n = 130,361
- Very low COIn = 81,739reference
- Outcome
- Up-to-date preventive care and immunization status; obesity, adolescent depression and suicidality, maternal depression and suicidality
Methodological detailsobservational, electronic health record data, multivariable mixed-effects logistic regression, Data analyzed in December 2022
- Observational
- Electronic health record data
- Multivariable mixed-effects logistic regression
- Data analyzed in December 2022
Main finding
As reported in the abstract
Up-to-date preventive visits, immunizations, obesity, adolescent and maternal depression and suicidality
Each group vs very low COIEstimate (95% CI)
Very high COI
OR (up-to-date preventive visits) 1.40(1.32–1.48)
Very high COI
OR (up-to-date immunizations) 1.77(1.58–2.00)
Very high COI
OR (obesity) 0.55(0.52–0.58)
Very high COI
OR (adolescent depression) 0.78(0.72–0.84)
Very high COI
OR (adolescent suicidality) 0.79(0.73–0.85)
Very high COI
OR (maternal depression) 0.78(0.72–0.86)
Very high COI
OR (maternal suicidality) 0.71(0.61–0.83)
Observational data: associations, not effects.
Original publication
Measures of Neighborhood Opportunity and Adherence to Recommended Pediatric Primary Care. JAMA Netw Open. Published 1 August 2023. doi:10.
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