Creating small-area deprivation indices: a guide for stages and options

Allik, Mirjam; Leyland, Alastair H.; Ichihara, Maria Yury; Dundas, Ruth

doi:10.1136/jech-2019-213255

Cited by 78 publications

(91 citation statements)

References 38 publications

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“…To further improve the interpretability of the index, we then applied a shrinkage procedure to reduce uncertainty and extreme values in the index by 'borrowing strength' from larger or nearby areas. 18 This method, often used in small area indices copyright.…”

Section: Discussionmentioning

confidence: 99%

How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI)

Daras

Alexiou

Rose

et al. 2021

J Epidemiol Community Health

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BackgroundDuring the initial wave of the COVID-19 epidemic in England, several population characteristics were associated with increased risk of mortality—including, age, ethnicity, income deprivation, care home residence and housing conditions. In order to target control measures and plan for future waves of the epidemic, public health agencies need to understand how these vulnerabilities are distributed across and clustered within communities.MethodsWe performed a cross-sectional ecological analysis across 6789 small areas in England. We assessed the association between COVID-19 mortality in each area and five vulnerability measures relating to ethnicity, poverty, prevalence of long-term health conditions, living in care homes and living in overcrowded housing. Estimates from multivariable Poisson regression models were used to derive a Small Area Vulnerability Index.ResultsFour vulnerability measures were independently associated with age-adjusted COVID-19 mortality. Each SD increase in the proportion of the population (1) living in care homes, (2) admitted to hospital in the past 5 years for a long-term health condition, (3) from an ethnic minority background and (4) living in overcrowded housing was associated with a 28%, 19% 8% and 11% increase in age-adjusted COVID-19 mortality rate, respectively.ConclusionVulnerability to COVID-19 was noticeably higher in the North West, West Midlands and North East regions, with high levels of vulnerability clustered in some communities. Our analysis indicates the communities who will be most at risk from a second wave of the pandemic.

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Section: Discussionmentioning

confidence: 99%

How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI)

Daras

Alexiou

Rose

et al. 2021

J Epidemiol Community Health

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show abstract

“…A small-area multiple index of deprivation, such as the English Index of Multiple Deprivation (32,844 small areas) [35,36] or the Scottish Index of Multiple Deprivation (6505 small areas) [37], would have strengthen our approach. There are extensive requirements for creating such a small-area deprivation index [38], and various proxys of deprivation are available in different countries. To our knowledge, such an index is nevertheless not currently available for Sweden.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Disease mapping of early- and late-stage cancer to monitor inequalities in early detection: a study of cutaneous malignant melanoma

et al. 2020

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We consider disease mapping of early-and late-stage cancer, in order to identify and monitor inequalities in early detection. Our method is demonstrated by mapping cancer incidence at high geographical resolution using data on 10,302 cutaneous malignant melanoma (CMM) cases within the 3.7 million population of SouthWest Sweden. The cases were geocoded into small-areas, each with a population size between 600 and 2600 and accessible socio-demographic data. Using the disease mapping application Rapid Inquiry Facility (RIF) 4.0, we produced regional maps to visualise spatial variations in stage I, II and III-IV CMM incidences, complemented by local maps to explore the variations within two urban areas. Pronounced spatial disparities in stage I CMM incidence were revealed by the regional and local maps. Stage I CMM incidence was markedly higher in wealthier small-areas, in particular within each urban area. A twofold higher stage I incidence was observed, on average, in the wealthiest small-areas (upper quintile) than in the poorest small-areas (lower quintile). We identified in the regional map of stage III-IV CMM two clusters of higher or lower than expected late-stage incidences which were quite distinct from those identified for stage I. In conclusion, our analysis of CMM incidences supported the use of this method of cancer stage incidence mapping for revealing geographical and socio-demographic disparities in cancer detection.

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“…To capture small-area socioeconomic deprivation, a variety of deprivation measures have been developed [19,20]. These measures generally cover multiple dimensions of deprivation, such as income, employment, education, social class, and housing conditions.…”

Section: Introductionmentioning

confidence: 99%

“…To avoid normative judgment that is inevitably involved in any weighting, the principal component and factor analysis approaches, which assign a set of weights that statistically best explain the variation in the data, have also been often used [24][25][26]. Because all of these approaches are known to have both advantages and disadvantages and have no clear theoretical background [19], it may be useful to compare their results and assess their robustness.…”

Section: Introductionmentioning

confidence: 99%

How does area-level deprivation depress an individual’s self-rated health and life satisfaction? Evidence from a nationwide population-based survey in Japan

Oshio

Kimura²,

Nishizaki

et al. 2020

Preprint

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Background: Area-level deprivation is well known to have an adverse impact on mortality, morbidity, or other specific health outcomes. This study examined how area-level deprivation may affect self-rated health (SRH) and life satisfaction (LS), an issue that is largely understudied.Methods: We used individual-level data obtained from a nationwide population-based internet survey conducted between 2019–2020, as well as municipality-level data obtained from a database provided by the Japanese government (N=12 461 living in 366 municipalities). We developed multilevel regression models to explain an individual’s SRH and LS scores using four alternative measures of municipality-level deprivation, controlling for individual-level deprivation and covariates. We also examined how health behavior and interactions with others mediated the impact of area-level deprivation on SRH and LS.Results: Participants in highly deprived municipalities tended to report poorer SRH and lower LS. For example, when living in municipalities falling in the highest tertile of municipality-level deprivation as measured by the z-scoring method, SRH and LS scores worsened by a standard deviation of 0.05 (p<0.05) when compared with those living in municipalities falling in the lowest tertile of deprivation. In addition, health behavior mediated between 17.6 % and 33.1 % of the impact of municipality-level deprivation on SRH and LS, depending on model specifications.Conclusion: This study showed that area-level deprivation modestly depressed an individual’s general health conditions and subjective well-being. The results underscore the need for public health policies to improve area-level socioeconomic conditions and to promote healthy lifestyles to alleviate the negative impact of area-level deprivation.

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Creating small-area deprivation indices: a guide for stages and options

Cited by 78 publications

References 38 publications

How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI)

How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI)

Disease mapping of early- and late-stage cancer to monitor inequalities in early detection: a study of cutaneous malignant melanoma

How does area-level deprivation depress an individual’s self-rated health and life satisfaction? Evidence from a nationwide population-based survey in Japan

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