A composite socioeconomic deprivation index from All of Us survey data: associations with health outcomes and disparities

Socioeconomic deprivation - defined as a lack of social, economic and material resources - is associated with poor health outcomes and health disparities between population groups. The All of Us Research Program is a longitudinal cohort study of diverse participants from the United States, with demographic and social determinants of health data gleaned from participant surveys and health outcome data derived from electronic health records. We developed a composite index of socioeconomic deprivation (iSDI) using a cohort of 202,919 All of Us participants - based on education, employment, health insurance, housing, and income data - and we associated iSDI with health outcomes and disparities. iSDI is significantly associated with 970 out of 1,755 (55.3%) health conditions modeled here, with 661 positive and 309 negative associations. Mental disorders and circulatory diseases show the highest proportion of positive associations with iSDI, whereas neoplasms and congenital anomalies show the highest proportion of negative associations. Black (0.55) and Hispanic (0.52) All of Us participants show higher average iSDI values compared to White (0.29) and Asian (0.24) participants; although the majority of iSDI variation is found within (76.8%) rather than between (23.2%) groups. iSDI mediates 213 out of 399 (53.5%) Black health disparity conditions and 173 out of 297 (58.2%) Hispanic health disparity conditions. The composite socioeconomic deprivation index (iSDI) developed here is associated with a wide variety of health outcomes and disparities in the All of Us cohort, and we make participant iSDI values available on the Researcher Workbench to support future studies on social determinants of health.