Date of Award


Embargo Period


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Mary Dooley

Second Advisor

Kit Simpson

Third Advisor

Jiebing Wen


The COVID-19 pandemic elevated public awareness of the impact of health inequities and the role that social determinants of health (SDOH) play in population health outcomes. Despite the utility, healthcare providers remain ill-informed on the community level SDOH data needed to improve health outcomes due to this information not being integrated into the Electronic Health Record (EHR) (Cantor and Thorpe, 2018; Park, 2018). Therefore, the association between community and environmental SDOH variables at the zip code level, using North Carolina hospital admissions data for infant mortality, adult mortality, and ambulatory care sensitive conditions (ACSC) were evaluated through logistic regression to determine the impact of the social vulnerability index (SVI) on health outcomes. Whereby, high SVI (OR=1.13, 95% CI: 1.05-1.23) was associated with 13 percent increased risk of infant mortality, 15 percent increased odds of adult mortality (OR=1.15, 95% CI: 1.06-1.25), and 19 percent increased odds of ACSC diagnosis (OR=1.19, 95% CI: 1.14-1.23), among those admitted to the hospital, when controlling for age, sex, and insurance status.


All rights reserved. Copyright is held by the author.