Characteristics of composite deprivation indices used in public health: a scoping review protocol

Background: Deprivation index has become a more popular tool to rank levels of deprivation within different geographic areas. It is extensively used for monitoring health inequalities, evaluating health care services, developing and modifying health policies and programs, and allocating health resources equitably. In the current review, we will examine how in different countries deprivation indices were created. This is significant because indices have been used in public health for more than three decades. The first deprivation index was created in the UK in the late 1980s. A stock of knowledge and information about deprivation indices have been accumulated over this period. Our objectives are to explore the relevant literature to describe features of composite deprivation measures; create a list and classification of original deprivation indices. We will develop the classification of indices to systematize knowledge and improve the functional utility of the information. Moreover, the classification will provide an organized framework for planning and following through with the process of developing new deprivation measures.Methods: Any original deprivation index mentioned in peer-reviewed or grey literature documents will be eligible for inclusion if it assesses deprivation at a population level and used in relation to health. The study area will be limited to the geographic areas of North America, Europe, Australia, and New Zealand. PubMed and grey literature databases will be searched to identify all relevant studies, without publication date restriction. Papers published in any language will be included to avoid language bias. Papers will be screened for inclusion by two independent reviewers. Tables and a narrative summary will be used to describe features of deprivation indices. Diagrammatic form will be used to create the classification of deprivation indices.Discussion: The aim of creating a taxonomy is to systematize information related to the methodology for constructing and using deprivation indices in public health research and practice. Practically, the results of this study could facilitate finding a common language among researchers and specialists who create and use deprivation indices, thus helping the development and implementation of appropriate deprivation indices for different countries.

Estimating equivalence scales and non-food needs in Egypt: Parametric and semiparametric regression modeling

This paper investigated the appropriate specifications of Engel curves for non-food expenditure categories and estimated the deprivation indices of non-food needs in rural areas using a semi parametric examination of the presence of saturation points. The study used the extended partial linear model (EPLM) and adopted two estimation methods—the double residual estimator and differencing estimator—to obtain flexible shapes across different expenditure categories and estimate equivalence scales. We drew on data of the Egyptian Household Income, Expenditure, and Consumption Survey (HIEC). Our paper provides empirical evidence that the rankings of most non-food expenditure categories is of rank three at most. Rural households showed high economies of scale in non-food consumption, with child’s needs accounting for only 10% of adult’s non-food needs. Based on semi-parametrically estimated consumption behavior, the tendency of non-food expenditure categories to saturate did not emerge. While based on parametrically estimated consumption behavior, rural areas exhibited higher deprivation indices in terms of health and education expenditure categories, which indicates the need to design specific programs economically targeting such vulnerable households.

Conclusion

The concluding chapter summarises the key findings and suggests policy recommendations. Part I delineated the pernicious impacts of neoliberalism and austerity on public/social housing in London, and analysed the role that estate demolition has played. Part II cast a sociological gaze not only at how working-class housing, lives and spaces are materially deprived and symbolically devalued by powerful external forces (neoliberalism and austerity), but also at how such housing, lives and spaces become valued and valuable. This emphasis on positive values corrects those policy perspectives that view estates through the epistemologically narrow lens of quantitative area-based deprivation indices. In comparative urbanism terms, London social housing estates remain substantially different from the anomic, often dangerous spaces of urban marginality such as US public housing projects (Wacquant). Part III focused on residents’ experiences of living through regeneration. It demonstrated how the valuation/devaluation duality tilts around in terms of place belonging. Comprehensive redevelopment diminishes the valued aspects of estates, while the devalued aspects are heightened and eventually dominate. The book provides several policy recommendations and research agendas. Demolition-based regeneration schemes inevitably result in state-led gentrification, but refurbishment-only schemes have the potential to improve estates and residents’ lives.

Deprivation Indices in China: Establishing Principles for Application and Interpretation

IndicesofMultiple Deprivation(IMDs) aim to measure living standards at the small area level. These indices were originally developed in the United Kingdom, but there is a growing interest in adapting them for use in China. However, due to data limitations, Chinese deprivation indices sometimes diverge considerably in approaches and are not always connected with the underlying concepts within UK analysis. In this paper, we seek to bring direction and conceptual rigour to this nascent literature by establishing a set of core principles for IMD estimation that are relevant and feasible in the Chinese context. These principles are based on specifying deprivation domains from theory, selecting the most appropriate measurements for these domains, and then applying rigorous statistical techniques to combine them into an IMD. We apply these principles to create an IMD for Shijiazhuang, the capital city of Hebei Province. We use this to investigate the spatial patterns of deprivation in Shijiazhuang, focussing on clusteringand centralisationof deprivation as well as exploring different deprivation typologies. We highlight two distinct types of deprived areas. One is clustered in industrial areas on the edge of the city, while the second is found more centrally and contains high proportions of low-skilled service workers.

Age Differences in Material Deprivation in Finland: How do Consensus and Prevalence-Based Weighting Approaches Change the Picture?

While material deprivation is often used to measure poverty, analyses focusing on the measurement of material deprivation are scarce. This study provides new information on material deprivation by analyzing how differences in the considerations of necessities and possession of deprivation items among all respondents and within population subgroups affect group-level differences in material deprivation in Finland. In line with many previous studies on material deprivation, this study focused on age groups. There is a significant age gradient regarding considerations of necessities, possession, and deprivation of many deprivation items. On average, younger adults experience material deprivation more often than older adults do. This study considers the differences in the considerations of necessities and possession of deprivation items using different weighting approaches. The study found that these differences are not largely transmitted to deprivation indices. Two causes of this finding were found: (1) individuals, on average, are not deprived of items in which there are differences between age groups regarding consensus and prevalence and (2) in those items in which deprivation is high, the consensus and the prevalence rates are often lower compared to other items. The results provide new information on which factors are important when using weighting approaches to measure material deprivation.

To what extent are social determinants of health, including household overcrowding, air pollution and housing quality deprivation, modulators of presentation, ITU admission and outcomes among patients with SARS-COV-2 infection in an urban catchment area in Birmingham, United Kingdom?

Background: Internationally, researchers have called for evidence to support tackling health inequalities during the Severe acute respiratory syndrome coronavirus 2(COVID19) pandemic. UK Office for National Statistics data suggests that patients in regions of most deprived overall, generic Index of Multiple Deprivation Score(IMDS) are twice as likely to die of COVID19 than other causes. The Intensive Care National Audit and Research Centre (ICNARC) report that BAME patients account for 34% of critically ill COVID19 patients nationally despite constituting 14% of the population. This paper is the first to explore the roles of social determinants of health, including specific IMDS sub-indices with indicators for household quality deprivation, household overcrowding deprivation and air pollution deprivation, as modulators of presentation, Intensive Care Unit(ITU) admission and outcomes among COVID19 patients of all ethnicities. Methods: An in-depth retrospective cohort study of 408 hospitalised COVID19 patients admitted to the Queen Elizabeth Hospital, Birmingham was conducted. Quantitative data analyses including two-step cluster analyses were applied. Results: Patients admitted from highest living environment(LE) deprivation indices were at increased risk of presenting with multi-lobar pneumonia and, in turn, ITU admission whilst patients admitted from highest Barriers to Housing and Services(BHS) deprivation indices were at increased risk of ITU admission. Admission to ITU significantly increased the risk of death. Black, Asian and Minority Ethnic(BAME) patients were more likely, than white patients, to present with multi-lobar pneumonia, be admitted to ITU and be admitted from highest BHS and LE deprivation indices. Comorbidities and frailty significantly increased the risk of death among COVID19 patients irrespective of deprivation.Conclusions: Air pollution and housing quality deprivation are potential modulators of presentation with multi-lobar pneumonia. Household overcrowding deprivation and presentation with multi-lobar pneumonia are potential modulators of ITU admission. Patents of BAME ethnicity are more likely to be admitted from regions of highest air pollution, housing quality and household overcrowding deprivation; this is likely to contribute an explanation towards the higher ITU admissions reported among COVID19 BAME patients. These findings have urgent implications for supporting front line clinical decisions, disseminating practical advice around applying social distancing messages at the household level and informing wider pandemic strategy.