A standard procedure for constructing a multi-level social vulnerability index using CLSA and SOS data as working examples

The construct of social vulnerability attempts to understand social circumstances not merely as a descriptor, but as a predictor of adverse health events. It can be measured by aggregating social deficits in a social vulnerability index (SVI). We describe a standard procedure for constructing a multi-level SVI using two working examples. First, we describe a six-step approach to constructing a SVI. Then, we conducted a secondary analysis of a clinical dataset (Canadian Immunization Research Network's Serious Outcomes Surveillance Network (SOS)) and a population-based dataset (Canadian Longitudinal Study on Aging (CLSA)). In both datasets, we construct SVIs, use descriptive statistics to report distributions by age and sex, and perform a multivariable linear regression of social vulnerability on frailty. Procedures for drafting a list of candidate social items, selecting deficits for inclusion, and screening deficits to meet inclusion criteria were applied to yield a 18-deficit SVI for the SOS and 74-deficit SVI for the CLSA. Deficits in each SVI were re-scored between 0 and 1, where 1 indicates the greater risk. Finally, the sum of all deficits is calculated into an index. In the SOS, SVI was associated with age only for females and was weakly associated with frailty (r = 0.26, p