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Understanding Communities of Deep Disadvantage

What does disadvantage look like in America? And where are the nation’s most disadvantaged communities? With funding from the Robert Wood Johnson Foundation, a team of researchers from the University of Michigan and Princeton University explored this question and developed an Index of Deep Disadvantage to identify and better understand America’s most disadvantaged communities.

Index of Deep Disadvantage
To understand disadvantage across the U.S., researchers developed an Index of Deep Disadvantage using the same data for both counties and cities, which allows for direct comparison. This index represents a holistic look at disadvantage, using health indicators (life expectancy, low infant birth weight), poverty metrics (rates of poverty and deep poverty), and social mobility data (Opportunity Insights Mobility Metrics).

This measure of disadvantage is complemented by local perspectives that provide a deeper understanding of America’s most vulnerable communities. By painting a vivid portrait of the conditions in the nation’s most disadvantaged communities, the index not only uncovers what factors drive disparities, but it can help pinpoint where policymakers, state and local leaders, and residents can take action to improve health, well-being, and opportunity for all.

Project Overview (PDF)

Principal Investigators

Stories from the Field

Karen Otzen Kling profile photoSocial infrastructure and recent surges in opioid-related deaths amid the pandemic
By Karen Otzen Kling
According to the American Medical Association, more than 35 U.S. states have reported an increase in opioid-related deaths since the start of the COVID-19 pandemic. Some addiction experts argue that social isolation resulting from the social distancing guidelines required to slow the spread of the virus may be helping to fuel the surge in opioid overdoses.


emily miller profile photoHometown heroes hold up social safety net in rural Kentucky
By Emily Miller
Barreling up a hill on dusty, dirt road, the gravel crunches and a rainbow of green flanks the narrow roads. It is a muggy Monday mid-afternoon just outside Manchester, Kentucky. I am in a van stacked with freshly cooked and packaged meals for seniors. The lead…


Disinvestment in rural Kentucky leaves ‘nothing to do’ but drugs
By Liv Mann
Clay County is tucked away among the rolling mountains of eastern Kentucky. It’s home to just over 20,000 people, but less than 1,400 live in the county seat, Manchester. The rest of the population is strewn throughout the county in towns like Oneida or tucked…


Murky homeownership status derails flood relief in South Carolina
By Jasmine Simington
Jerry Testle is tucked into the arm of his living room couch watching television when a local community leader escorts us into his home. He can barely adjust his body to greet us, and he smiles only with his lips when we introduce ourselves…


Moving the needle on syringe exchanges in Appalachian Kentucky
By Lanora Johnson
There are no sidewalks on either side of the narrow road that leads toward Angel’s house, tucked away in a shallow holler in Clay County, Kentucky. The faded asphalt gives way to Angel’s yard — large and hilly, home to a bleating goat, chickens and at least three dogs…


Flood Recovery out of Reach in Rural South Carolina
By Meg Duffy
Water seeped under the doors of old homes and trailers in Nichols as the flooding from Hurricane Matthew began. Nichols is situated just north of the confluence of the Lumber and Little Pee Dee rivers, so as 18 inches of rain pelted the Carolinas, water came flooding into Nichols, bringing….


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