Validation of a deprivation index for public health: a complex exercise illustrated by the Quebec index

Pampalon, Robert; Hamel, Denis; Gamache, Philippe; Simpson, André; Philibert, Mathieu

doi:10.24095/hpcdp.34.1.03

Cited by 88 publications

(43 citation statements)

References 68 publications

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“…It is, therefore, an ideal location to examine the links between PM and socioeconomic deprivation. This study evaluates the relationship between social and material deprivation and PM in NS using a recently validated index [ 26 ]. It also quantifies the number and proportion of premature deaths directly attributable to socioeconomic deprivation, were the association considered to be causal.…”

Section: Introductionmentioning

confidence: 99%

Premature mortality due to social and material deprivation in Nova Scotia, Canada

Saint-Jacques

Dewar

Cui

et al. 2014

Int J Equity Health

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IntroductionInequalities in health attributable to inequalities in society have long been recognized. Typically, those most privileged experience better health, regardless of universal access to health care. Associations between social and material deprivation and mortality from all causes of death— a measure of population health, have been described for some regions of Canada. This study further examines the link between deprivation and health, focusing on major causes of mortality for both rural and urban populations. In addition, it quantifies the burden of premature mortality attributable to social and material deprivation in a Canadian setting where health care is accessible to all.MethodsThe study included 35,266 premature deaths (1995–2005), grouped into five causes and aggregated over census dissemination areas. Two indices of deprivation (social and material) were derived from six socioeconomic census variables. Premature mortality was modeled as a function of these deprivation indices using Poisson regression.ResultsPremature mortality increased significantly with increasing levels of social and material deprivation. The impact of material deprivation on premature mortality was similar in urban and rural populations, whereas the impact of social deprivation was generally greater in rural populations. There were a doubling in premature mortality for those experiencing a combination of the most extreme levels of material and social deprivation.ConclusionsSocioeconomic deprivation is an important determinant of health equity and affects every segment of the population. Deprivation accounted for 40% of premature deaths. The 4.3% of the study population living in extreme levels of socioeconomic deprivation experienced a twofold increased risk of dying prematurely. Nationally, this inequitable risk could translate into a significant public health burden.

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Section: Introductionmentioning

confidence: 99%

Premature mortality due to social and material deprivation in Nova Scotia, Canada

Saint-Jacques

Dewar

Cui

et al. 2014

Int J Equity Health

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“…However, this index was developed using census data for the smallest geographical area for which it was possible to obtain these data and that contained a relatively homogenous population of residents. 33 In addition, except for the slight differences reported above, our results were not sensitive to changes in the method for measuring SES (individual vs. geographically based deprivation index). The slight differences observed indicate that research taking into account both individual socioeconomic factors and the neighbourhood environment is still needed to deepen our understanding of the mechanisms linking deprivation and exposure to ADT.…”

Section: Discussionmentioning

confidence: 49%

“…This deprivation index is widely used, 34 –36 and evidence supports its temporal stability and predictive validity. 32,33 This index also correlates with SES measured at an individual level. 33…”

Section: Methodsmentioning

confidence: 90%

“…32 No individual socioeconomic data are available in Quebec administrative databases, and this index was developed and integrated in numerous administrative databases such as those of the RAMQ to allow for the exploration of social inequalities. 33 Based on the Canadian census data, this index is assigned to each DA. The DA is the smallest area for which it is possible to obtain census data (400-700 individuals), and each DA corresponds to a postal code.…”

Section: Methodsmentioning

confidence: 99%

“…We also adjusted for residency area, as defined by Statistics Canada (Montreal metropolitan region area, other metropolitan areas [>100,000 inhabitants], towns of 10,000-100,000 inhabitants, and rural and small-town areas [<10,000 inhabitants]) 46 as recommended by the developers of the deprivation index because deprivation levels are more variable in DA covering small cities and rural areas than those in urban areas. 33,47…”

Section: Methodsmentioning

confidence: 99%

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Neighbourhood Material and Social Deprivation and Exposure to Antidepressant Drug Treatment: A Cohort Study Using Administrative Data

et al. 2018

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Hidradenitis Suppurativa and Maternal and Offspring Outcomes

Li,

Piguet,

Croitoru

et al. 2024

JAMA Dermatol

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ImportanceHidradenitis suppurativa (HS) is associated with morbidity in persons of reproductive age, but the effect on maternal and offspring outcomes is understudied.ObjectiveTo determine the association of HS with pregnancy outcomes and maternal and child morbidity in the long term.Design, Setting, and ParticipantsThis population-based longitudinal cohort study with up to 16 years of follow-up took place between 2006 and 2022 in Quebec, Canada. .ExposureMaternal HS.Main Outcomes and MeasuresOutcomes included hypertensive disorders of pregnancy, gestational diabetes, and other birth outcomes as well as the long-term risk of hospitalization up to 16 years after delivery. The study used adjusted log-binomial and Cox proportional hazards regression models to estimate the association between maternal HS and pregnancy outcomes or hospitalization following pregnancy. Outcomes in both mothers and offspring were assessed.ResultsThere were 1 324 488 deliveries during the study, including 1332 (0.1%) among mothers with HS. Compared with patients without HS, patients with HS had a greater risk of hypertensive disorders of pregnancy (risk ratio [RR], 1.55 [95% CI, 1.29-1.87]), gestational diabetes (RR, 1.61 [95% CI, 1.40-1.85]), and severe maternal morbidity (RR, 1.38 [95% CI, 1.03-1.84]). In neonates, maternal HS was associated with risk of preterm birth (RR, 1.28 [95% CI, 1.07-1.53]) and birth defects (RR, 1.29 [95% CI, 1.07-1.56]). In the long term, HS was associated with 2.29 times the risk of maternal hospitalization (95% CI, 2.07-2.55) and 1.31 times the risk of childhood hospitalization (95% CI, 1.18-1.45), including hospitalization for respiratory, metabolic, psychiatric, and immune-related morbidity over time.Conclusions and RelevanceThis cohort study found that HS is associated with adverse maternal and offspring outcomes in the peripartum period and in the long term. Early detection and management of HS may help mitigate these outcomes.

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Validation of a deprivation index for public health: a complex exercise illustrated by the Quebec index

Cited by 88 publications

References 68 publications

Premature mortality due to social and material deprivation in Nova Scotia, Canada

Premature mortality due to social and material deprivation in Nova Scotia, Canada

Neighbourhood Material and Social Deprivation and Exposure to Antidepressant Drug Treatment: A Cohort Study Using Administrative Data

Hidradenitis Suppurativa and Maternal and Offspring Outcomes

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