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 (β = 62.56; SE = 6.28; p < 0.001) and West South Central (β = 66.75; SE = 5.33; p < 0.001) Census divisions. Among index themes, socioeconomic status (β = 25.56; SE = 1.16; p < 0.001), household composition (β = 23.49; SE = 1.00; p < 0.001), and minority/language status (β = 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.
Keywords: Community health needs assessment; Social Vulnerability Index; Social determinants of health; Spatial analysis; Teen pregnancy.