Assessing Community Risk to Inform Health Policy

By Shannon Sweeney | October 2022


The conditions in which people live, learn, work and play can influence health outcomes as well as other well-being conditions related to employment, access to education and community engagement. Many of these conditions, known as social drivers or determinants of health, can also influence how communities are affected by things like natural disasters or economic crises. As some policymakers consider social drivers in policy decisions, the Centers for Disease Control and Prevention and Agency for Toxic Substance and Disease Registry Social Vulnerability Index can be a helpful tool in assessing community risk related to social determinants of health. While the SVI traditionally has been used to evaluate vulnerable populations and geographic areas following natural disasters, the index is emerging as a resource capable of explaining the interaction between social determinants of health and other public health concerns.

Understanding the Social Vulnerability Index

The CDC’s Social Vulnerability Index can be used to identify “socially vulnerable” populations or areas susceptible to various hazards caused by external factors, including natural or human-caused disasters and disease outbreaks. Fifteen key variables, including socioeconomic status, household composition, minority status, housing type and transportation, provide the basis for the SVI. In addition to emergency preparedness, the SVI can be adapted to track and evaluate public health risk, manage care, support social service referrals and reduce barriers to overall wellness.

State Action

The SVI historically has been used to identify communities in need of support before, during and after an environmental disaster. For example, after Hurricane Katrina Louisiana officials relied on the SVI as a policy tool in addressing recovery efforts. In collaboration with the CDC’s Office of Terrorism Preparedness and Emergency Response, the Agency for Toxic Substances and Disease Registry produced an SVI report to assist state partners in all phases of the disaster cycle, including preparedness, response and recovery.

As states look to better understand population health, the SVI can serve as a resource. As COVID-19 began to shine a light on health disparities in many communities, national partners, public health leaders and universities used the SVI to support community response. For example, based on SVI measurements, the Surgeon General collaborated with experts to establish over 240 testing centers in 33 states, resulting in 69% of the sites in communities with moderate to high social vulnerability. Similarly, the National Institute of Environmental Health Sciences, North Carolina State University and Texas A&M University developed a similar tool—the COVID-19 Pandemic Vulnerability Index, which included several SVI components, such as race and population density, to better understand how the virus was spreading and which communities could be at higher risk.

A couple of state legislatures have also used the SVI to inform public health policy. In 2022, Illinois enacted legislation directing financial resources to the state’s “most distressed communities” using data from the SVI. This included allocating funding to critical-access and safety net hospitals, as well as “areas disproportionately impacted by COVID-19.” In 2021, Massachusetts also utilized data from the SVI to allocate federal funding from the American Rescue Plan Act to “socially disadvantaged communities” in the state. By using the SVI, public health systems may better understand the impacts of disasters on the social determinants of health, improve response times and direct resources.

Federal Action

In recent years, Congress has considered how the SVI may be used in allocating funds to state and local health departments and has utilized it for analysis of pending legislation on the public health workforce, preventing maternal mortality and morbidity, and health equity, including access to vaccines.

 The CDC has also partnered with the Office of Minority Health within the U.S. Department of Health and Human Services to create the Minority Health Social Vulnerability Index (MH SVI), which helps to identify minority communities at risk for disproportionate impacts of COVID-19. Both the MH SVI and the SVI are based on data gathered by the U.S. Census Bureau. The data may help to inform policymakers’ understanding of potential challenges facing specific populations as well as inform public response by health systems.

State leaders who are interested in learning more about the SVI and its possible application in their communities can find additional information on the CDC/ATSDR Social Vulnerability Index webpage. The SVI has the potential to enhance the realm of emergency response and serve as a resource in the creation of population health policy.

This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $200,000 with 100% funded by the CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, the CDC/HHS or the U.S. government.