Are we measuring neighborhood disadvantage wrong? A methodological reassessment of its structure in the United States.

Neighborhood disadvantage (or deprivation) indices are increasingly used in population health research and policy. In the United States, many frequently used neighborhood disadvantage indices were originally derived in the late 1990s and early 2000s. However, the United States has undergone dramatic economic and social shifts in the past three decades, including the Great Recession, growing wealth inequality, and the changing nature of work in the "gig" economy. Yet few studies have re-evaluated the structure of neighborhood disadvantage to determine if the items included in existing indices continue to capture the contemporary US context. The purpose of this paper was to re-evaluate the construct of neighborhood disadvantage using national data on United States census tract characteristics from the 2018-2022 American Community Survey. We found that neighborhood disadvantage has evolved from its early 21st Century construct of the co-absence of economic, social, and family resources in the local neighborhood to more recently becoming a construct better captured only by economic indicators of poverty, public assistance income, and low income. We also found evidence for neighborhood affluence as a distinct construct from disadvantage. We recommend simplifying neighborhood disadvantage indices by including only a parsimonious set of economic items. We also recommend the use of a distinct neighborhood affluence index derived from items that are better related to this construct.