Removing the health domain from the Index of Multiple Deprivation 2004 - effect on measured inequalities in census measure of health
Removing the health domain from the Index of Multiple Deprivation 2004 - effect on measured inequalities in census measure of health
复制标题
DOI：
10.1093/pubmed/fdl061
复制
发表时间：
2006-12-01
影响因子：
4.4
通讯作者：
White, M.
中科院分区：
文献类型：
--
作者：
Adams, J.;White, M.
2004年多重贫困指数（IMD）是英格兰地区一级贫困的汇总衡量标准，结合了七个贫困领域的加权分数。IMD 2004被当地公共卫生部门和研究人员广泛用于描述和监测健康方面的社会经济不平等。然而，在IMD 2004中包括健康域导致“数学耦合”的可能性，其中IMD 2004和健康标记之间的关系通过在IMD 2004中包括健康来预测-有效地将健康的测量置于相关方程的两侧。我们探讨了从IMD 2004中删除健康领域对分配给贫困群体的小区域的影响，并测量了健康方面的不平等。IMD 2004年和IMD 2004-减健康（kappa = 0.895）分配给小地区的贫困五分位数之间有很好的一致性。删除健康领域对人口普查健康措施中所衡量的社会经济不平等几乎没有实际影响。这些发现可能不适用于其他健康指标，在健康方面的社会经济不平等的背景下，从IMD 2004中删除健康领域可能是最佳做法。
The Index of Multiple Deprivation (IMD) 2004 is a summary measure of area-level deprivation in England that combines weighted scores in seven deprivation domains. IMD 2004 is used extensively by local public health departments and researchers to describe and monitor socioeconomic inequalities in health. However, the inclusion of a health domain in IMD 2004 leads to the possibility of 'mathematical coupling' where a relationship between IMD 2004 and markers of health is predicated by the inclusion of health in IMD 2004-effectively placing measures of health on both sides of the correlation equation. We explored the effect of removing the health domain from IMD 2004 on assignment of small areas to deprivation groups and measured inequalities in health. There was excellent agreement between the deprivation quintiles that small areas were assigned to by IMD 2004 and IMD 2004-minus-health (kappa = 0.895). Removing the health domain had little, practical, effect on measured socioeconomic inequalities in census measures of health. These findings may not hold for other measures of health, and in the context of socioeconomic inequalities in health, removing the health domain from IMD 2004 probably represents best practice.