Calculating Social Vulnerability Index by ZIP Code

A paper by Ng, Zhang and Kowal (2025) use the American Community Survey (ACS) data from 2016–2022 were used to construct Social Vulnerability Index (SVI).  SVI is calculated from 16 social determinants of health (SDoH) variables that are grouped into 4 themes: socioeconomic status, household characteristics, racial and ethnic minority status, and housing type &…

The new OMB Social Welfare Function

Recently, the Office of Management and Budget has released new procedures to assess government regulation (Circular A-4) and economic policies (Circular A-94). What is unique about this guidance is that it weights benefits and costs of new regulations and policies based on the income of the individuals impacted. The goal is to help reduce inequality.…

Health and wealth

Are wealthier people healthier? If so, how strong is this relationship? Does it vary across countries? That is what a paper by Kyriopoulos et al. 2024 aims to answer. They measure health and wealth using a “concentration index” (CI) which is calculated as follows: CI is estimated with reference to the concentration curve, which illustrates…

Recommendations for incorporating equity into HTA evaluation

Many health policy experts–including myself–have noted that treatments that help reduce health disparities may be especially valuable whereas those that exacerbate inequalities may be somewhat less valuable than predicted by standard cost-effectiveness analysis. A key question is, health disparities over what dimension(s)? Is it race? Income? Education? O’Nell et al. (2013) developed the PROGRESS framework.…

How do social determinants of health impact health outcomes?

There are many studies that show that social determinants of health (SDOH) impact health outcomes. A more challenging question is how do SDOH impact health outcomes? Specifically, through what pathways or mechanisms do SDOH operate? A paper by Thimm-Kaiser (2023) identifies 8 mechanisms through which SDOH impact outcomes. These include: SDOH are underlying causes of…

Distributional Cost Effectiveness Analysis: A simple example

I have written previously about the need for distributional cost-effectiveness analysis (DCEA) which would increase the value of treatments who improve the health for individuals who currently have the worst expected quality-adjusted life expectancy (QALE). I’ve written about this in AJMC and Health Affairs among other places. One key question many individuals may have is…