Disadvantage indices as a way of operationalizing intersectionality in health equity: taking stock and next steps.

This interdisciplinary panel combines perspectives from scholars in clinical medicine, law, health policy, and bioethics. All speakers take as their point of departure the unprecedented uptake of disadvantage indices (DI) in Covid-19, especially in vaccine allocation, when the majority of US states used indices to promote health equity. DIs are typically based on census data and integrate around 15 variables (including income, education, housing quality) to compute an overall score that captures, how disadvantaged, on average, people living in a particular area are, capturing directly the link of health and place, and typically also health, place and race/ethnicity. The first speaker is a Professor of law. She will speak about the intersection of race, ethnicity and disadvantage, and outline the relevance of DIs for addressing racial and ethnic equity. The second speaker is a Professor of Medicine. She will describe the uses of the Social Vulnerability Index (SVI) in the state of Michigan, In Covid vaccine allocation and other areas. The third speaker is a policy maker in the state of Oregon. She will describe the way in which the state drew on the DIs in reviewing its Crisis Standards of Care. The fourth speaker is an Assistant Professor of Medical Ethics and Health Policy. He will address differences in the design of major DIs, and unfold their relevance of design differences for impacting equity, along with a scoping review of uses of DIs in the published literature.