Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Urban Health
Published in: Journal of Urban Health 4/2007

01-07-2007

Deprivation Indices, Population Health and Geography: An Evaluation of the Spatial Effectiveness of Indices at Multiple Scales

Authors: Nadine Schuurman, Nathaniel Bell, James R. Dunn, Lisa Oliver

Published in: Journal of Urban Health | Issue 4/2007

Login to get access

Abstract

Area-based deprivation indices (ABDIs) have become a common tool with which to investigate the patterns and magnitude of socioeconomic inequalities in health. ABDIs are also used as a proxy for individual socioeconomic status. Despite their widespread use, comparably less attention has been focused on their geographic variability and practical concerns surrounding the Modifiable Area Unit Problem (MAUP) than on the individual attributes that make up the indices. Although scale is increasingly recognized as an important factor in interpreting mapped results among population health researchers, less attention has been paid specifically to ABDI and scale. In this paper, we highlight the effect of scale on indices by mapping ABDIs at multiple census scales in an urban area. In addition, we compare self-rated health data from the Canadian Community Health Survey with ABDIs at two census scales. The results of our analysis confirm the influence of spatial extent and scale on mapping population health—with potential implications for health policy implementation and resource distribution.
Literature
1.
Carstairs V, Morris R. Which deprivation? A comparison of selected deprivation indices. J Public Health Med. 1991;13:318–326.PubMed
2.
Jarman B. Identification of underprivileged areas. BMJ. 1983;286:1705–1708.PubMed
3.
Jarman B. Deprivation Indices. BMJ. 1991;303(523).
4.
Marmot M, Wilkinson R. Social Determinants of Health. Oxford: Oxford University Press; 1999.
5.
Townsend P, Davidson N, Whitehead M. The Black Report and the Health Divide. Penguin; 1986.
6.
Bartley M, Blane D. Commentary: “Appropriateness of deprivation indices must be ensured”. BMJ. 1994;309:1479.PubMed
7.
Black D, Morris JN, Smith P, Townsend P. Inequalities in Health: Report of a Research Working Group (Black Report). London: Department of Health and Social Security; 1980.
8.
Marmot MG. Social Inequalities in Mortality: The Social Environment. In: Wilkinson RG, ed. Class and Health: Research and Longitudinal Data. London: Tavistock; 1986:21–33.
9.
Acheson D. Independent Inquiry Into Inequalities in Health. London: Stationary Office; 1998.
10.
Carstairs V. Deprivation: explaining differences in mortality between Scotland and England and Wales. BMJ. 1989;299:886–889.PubMed
11.
Frohlich KL, Mustard C. A regional comparison of socioeconomic and health indices in a Canadian province. Soc Sci Med. 1996;42(9):1273–1281.PubMedCrossRef
12.
Langlois A, Kitchen P. Identifying and measuring dimensions of urban deprivation in Montreal: an analysis of the 1996 Census Data. Urban Stud. 2001;38(1):119–139.CrossRef
13.
Pampalon R, Raymond G. A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000;21(3):104–113.PubMed
14.
Townsend P, Phillimore P, Beattie A. Health and Deprivation. London: Croom Helm; 1988.
15.
Martens PJ, Derksen S, Gupta S. Predictors of hospital readmission of Manitoba newborns within six weeks postbirth discharge: a population-based study. Pediatrics. 2004;114(3):708–713.PubMedCrossRef
16.
Martens PJ, Mayer T, Derksen S. Factors affecting adolescent reproductive health in Manitoba. Can J Public Health. 2002;93(Suppl 2):S39–S43.PubMed
17.
Odoi A, Wray R, Emo M, et al. Inequalities in neighborhood socioeconomic characteristics: potential evidence-base for neighborhood health planning. International Journal of Health Geographics. 2005;4(20):1–15.
18.
Rose D, Gilbert A. Glimpses of social and cultural geography in Canada and Québec at the turn of the millennium. Social and Cultural Geography. 2005;6(2):271–298.CrossRef
19.
Boyle MH, Willms JD. Place effects for areas defined by administrative boundaries. Am J Epidemiol. 1999;149(6):577–585.PubMed
20.
Reijneveld SA, Verheij RA, de Bakker DH. The impact of area deprivation on differences in health: does the choice of the geographical classification matter? J Epidemiol Community Health. 2000;54:306–313.PubMedCrossRef
21.
Townsend P. Life and Labour in London. London; 1987.
22.
Orpana HM, Lemyre L. Explaining the social gradient in health in Canada: using the National Population Health Survey to examine the role of stressors. Int J Behav Med. 2004;11(3):143–151.PubMedCrossRef
23.
Roos LL, Magoon J, Gupta S, Chateau D, Veugelers PJ. Socioeconomic determinants of mortality in two Canadian provinces: multilevel modelling and neighborhood context. Soc Sci Med. 2004;59(7):1436–1447.CrossRef
24.
Wagstaff A, van Doorslaer E. Overall versus socioeconomic health inequality: a measurement framework and two empirical illustrations. Health Econ. 2004;13(3):297–301.PubMedCrossRef
25.
Soobader M, LeClere FB. Aggregation and the measurement of income inequality: effects on morbidity. Soc Sci Med. 1999;48(6):733–744.PubMedCrossRef
26.
Soobader M, LeClere FB, Hadden W, Maury B. Using aggregate geographic data to proxy individual socioeconomic status: does size matter? Am J Public Health. 2001;91(4):632–636.PubMed
27.
Krieger N, Chen JT, Waterman PD, Rehkopf DH, Subramaniam SV. Race/Ethnicity, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures—the Public Health Disparities Geocoding Project. Am J Public Health. 2003;93(10):1655–1671.PubMed
28.
Epp J. Achieving Health for All: A Framework for Health Promotion: Government of Canada; 1986.
29.
Frank J. The determinants of health: a new synthesis. Canadian Institute for Advanced Research. Curr Issues Public Health. 1995;1:233–240.
30.
Spitzer DL. Engendering health disparities. Can J Public Health. 2005;S78–S96, March-April.
31.
Bell N, Schuurman N, Oliver L, Hayes MV. Constructing place-specific measures of deprivation using local knowledge: evaluating population health in Vancouver, British Columbia. Can Geogr. Submitted, 2006.
32.
Craig ED, Stewart AW, Mitchell EA. Causes of late fetal death in New Zealand 1980–1999. Aust N Z J Obstet Gynaecol. 2004;44(5):441–448.PubMedCrossRef
33.
Heaney DC, MacDonald BK, Everitt A, et al. Socioeconomic variation in incidence of epilepsy: prospective community based study in south east England. BMJ. 2002;325(7371):1013–1016.PubMedCrossRef
34.
Singh GK, Siahpush M. Increasing inequalities in all-cause and cardiovascular mortality among U.S. adults aged 25–64 years by area socioeconomic status, 1969–1998. Int J Epidemiol. 2002;31(3):600–613.PubMedCrossRef
35.
Carr-Hill RA, Sheldon T. Designing a deprivation payment for general practitioners: the UPA(8) wonderland. BMJ. 1991;302:393–396.PubMedCrossRef
36.
Davey-Smith G. Second thoughts on the Jarman Index—claims being made for the underprivileged area score are unproved. BMJ. 1991;302:359–360.
37.
Talbot RJ. Underprivileged areas and health care planning: implications of use of Jarman indicators of urban deprivation. BMJ. 1991;302, 16 February.
38.
Congdon P. Health status and healthy life measures for population health need assessment: modelling variability and uncertainty. Health Place. 2001;7:13–25.PubMedCrossRef
39.
Vidal-Rodeiro CL, Santiago-Pèrez MI, Vàzquex-Fernàdez E, Lòpez-Vizcaíno ME, Hervada-Vidal X. Geographical Analysis of Disease in Small Areas Using Hierarchical Bayesian Models: Mapping Men’s Lung Cancer Mortality in Galicia, Spain. In: Khan O, ed. Geographic Information Systems and Health Applications. Hershey, PA: Idea Group; 2003.
40.
Amrhein C, Wong D. Research on the MAUP: old wine in a new bottle or real breakthrough? Geogr Syst. 1996;3:73–76.
41.
Martin D. An Assessment of surface and zonal models of population. Int J Geogr Inf Syst. 1996;10(8):973–989.CrossRef
42.
Tate NJ. Guest editorial: surfaces for GIScience. Trans GIS. 2000;4(4):301–303.CrossRef
43.
A3B2 twb=.27w?>Unwin JD. GIS, spatial analysis and spatial statistics. Prog Hum Geog. 1996;20(4):540–541.
44.
Fotheringham AS, Wong DWS. The modifiable areal unit problem in multivariate statistical analysis. Environ & Plann A. 1991;23:1025–1044.CrossRef
45.
Openshaw S. The Modifiable Areal Unit Problem. CATMOG. 1984;38.
46.
Wrigley N, Holt T, Steel D, Tranmer M. Analysing, modelling, and resolving the ecological fallacy. In: Longley P, Batty M, eds. Spatial Analysis: Modelling in a GIS Environment. New York: John Wiley and Sons; 1996:23–40.
47.
Marceau DJ. The scale issue in social and natural sciences. Can J Remote Sens. 1999;25(4):347–356.
48.
Duckham M, Mason K, Stell J, Worboys M. A formal approach to imperfection in geographic information. Comput Environ Urban. 2001;25:89–103.CrossRef
49.
Bracken I, Martin D. The generation of spatial population distributions from census centroid data. Environ & Plann A. 1989;21(4):537–543.CrossRef
50.
Hyndman J, D’Arcy C, Holman J, Jamrozik K. The effect of spatial definition on the allocation of clients to screening clinics. Soc Sci Med. 1997;45(2):331–340.PubMedCrossRef
51.
Longley P. Geographical Information Systems: developments in socio-economic data infrastructures. Prog Hum Geog. 2003;27(1):114–121.CrossRef
52.
Statistics Canada. Canadian Community Health Survey—Guide. Ottawa: Statistics Canada, Health Statistics Division, Ministry of Industry; 2005.
53.
Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol. 1983;117:292–304.PubMed
54.
Miilunpalo S, Vuori I, Oja P, Pasanen M, Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997;50(5):517–528.PubMedCrossRef
55.
Cummins S, Macintyre S, Davidson S, Ellaway A. Measuring neighborhood social and material context: generation and interpretation of ecological data from routine and non-routine sources. Health Place. 2005;11(3):249–260.PubMedCrossRef
Metadata
Title
Deprivation Indices, Population Health and Geography: An Evaluation of the Spatial Effectiveness of Indices at Multiple Scales
Authors
Nadine Schuurman
Nathaniel Bell
James R. Dunn
Lisa Oliver
Publication date
01-07-2007
Published in
Journal of Urban Health / Issue 4/2007
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-007-9193-3

Other articles of this Issue 4/2007

Journal of Urban Health 4/2007 Go to the issue

Literature in Brief

Child and Adolescent Health

EditorialNotes

How Green is My City?

OriginalPaper

Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

Literature in Brief

Health Issues in Prisons and Jails: Implications for Urban Health

EditorialNotes

In the Heat of the Summer

OriginalPaper

Buying and Selling “Loosies” in Baltimore: The Informal Exchange of Cigarettes in the Community Context