Influence of area-level social vulnerability on all-cause pneumonia incidence among adult Medicare and Medicaid enrollees

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Publicado en:Communications Medicine vol. 5, no. 1 (Dec 2025), p. 467
Autor principal: Mohanty, Salini
Otros Autores: Shanmugam, Priya, Chatrath, Saumya, Cassell, Kelsie, Cossrow, Nicole, Fiduccia, Peter C., Smith-Howell, Esther, McGuinn, Valina C., Zurovac, Jelena, Delannoy, Constance, Evans, Alyssa, Barna, Michael, Keshaviah, Aparna, Feemster, Kristen A.
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Springer Nature B.V.
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024 7 |a 10.1038/s43856-025-01163-4  |2 doi 
035 |a 3272065107 
045 2 |b d20251201  |b d20251231 
100 1 |a Mohanty, Salini  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
245 1 |a Influence of area-level social vulnerability on all-cause pneumonia incidence among adult Medicare and Medicaid enrollees 
260 |b Springer Nature B.V.  |c Dec 2025 
513 |a Journal Article 
520 3 |a BackgroundThe incidence of pneumonia varies by demographic and clinical factors, but less is known about the influence of area-level social determinants of health.MethodsUsing Medicare and Medicaid claims, we characterized the relationship between the county-level Minority Health Social Vulnerability Index (MHSVI) and all-cause pneumonia (ACP), pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) incidence from 2016 to 2019.ResultsWe show that in Medicare ( ≥ 65 years, 55% female) and Medicaid (ages 19–64, 58% female), ACP incidence is 8052 and 1819 per 100,000 person-years, respectively. Across both cohorts, rates are highest among enrollees who are male, non-Hispanic white, older, at high risk for pneumococcal disease (those with immunocompromising or other serious conditions such as cancer), and rural county residents. Among high-risk Medicare and Medicaid enrollees, ACP incidence is higher in the most versus least socially vulnerable counties, whereas the opposite is observed among moderate-risk enrollees (those with chronic conditions such as diabetes) and low-risk enrollees (those without chronic or immunocompromising conditions).ConclusionsControlling for individual characteristics attenuated the relationship between vulnerability and disease incidence overall and in most subgroups. Within MHSVI themes, ACP incidence is higher for the most versus least vulnerable counties based on Medical Vulnerability and Household Composition and Disability themes versus the overall MHSVI. Results for secondary outcomes (PP and IPD) follows similar patterns as for ACP but are weaker in magnitude and significance.Mohanty et al. examine the link between county-level Minority Health Social Vulnerability Index and rates of all-cause pneumonia, pneumococcal pneumonia, and invasive pneumococcal disease from 2016 to 2019 among publicly insured U.S. adults. Findings show that pneumococcal disease rates are higher in the most socially vulnerable counties. 
651 4 |a United States--US 
653 |a Health care access 
653 |a Enrollments 
653 |a Diabetes 
653 |a Transplants & implants 
653 |a Pneumonia 
653 |a Medicaid 
653 |a Infrastructure 
653 |a Health care policy 
653 |a Disease 
653 |a Low income groups 
653 |a Pandemics 
653 |a Chronic illnesses 
653 |a Streptococcus infections 
653 |a Medicare 
653 |a COVID-19 
653 |a Health insurance 
700 1 |a Shanmugam, Priya  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Chatrath, Saumya  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Cassell, Kelsie  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
700 1 |a Cossrow, Nicole  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
700 1 |a Fiduccia, Peter C.  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
700 1 |a Smith-Howell, Esther  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
700 1 |a McGuinn, Valina C.  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
700 1 |a Zurovac, Jelena  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Delannoy, Constance  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Evans, Alyssa  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Barna, Michael  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Keshaviah, Aparna  |u Mathematica Inc, Princeton, USA (GRID:grid.419482.2) (ISNI:0000 0004 0618 1906) 
700 1 |a Feemster, Kristen A.  |u Merck & Co., Inc, Rahway, USA (GRID:grid.417993.1) (ISNI:0000 0001 2260 0793) 
773 0 |t Communications Medicine  |g vol. 5, no. 1 (Dec 2025), p. 467 
786 0 |d ProQuest  |t Healthcare Administration Database 
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856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3272065107/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3272065107/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch