Association Between Community Social Vulnerability and Preventable Hospitalizations

Med Care Res Rev. 2024 Feb;81(1):31-38. doi: 10.1177/10775587231197248. Epub 2023 Sep 21.


Preventable hospitalizations are common and costly events that burden patients and our health care system. While research suggests that these events are strongly linked to ambulatory care access, emerging evidence suggests they may also be sensitive to a patient's social, environmental, and economic conditions. This study examines the association between variations in social vulnerability and preventable hospitalization rates. We conducted a cross-sectional analysis of county-level preventable hospitalization rates for 33 states linked with data from the 2020 Social Vulnerability Index (SVI). Preventable hospitalizations were 40% higher in the most vulnerable counties compared with the least vulnerable. Adjusted regression results confirm the strong relationship between social vulnerability and preventable hospitalizations. Our results suggest wide variation in community-level preventable hospitalization rates, with robust evidence that variation is strongly related to a community's social vulnerability. The human toll, societal cost, and preventability of these hospitalizations make understanding and mitigating these inequities a national priority.

Keywords: preventable hospitalizations; social determinants of health; social vulnerability.

MeSH terms

  • Cross-Sectional Studies
  • Hospitalization*
  • Humans
  • Social Vulnerability*
  • United States