The Index of Multiple Deprivation 2000 and accessibility effects on health
The Index of Multiple Deprivation 2000 and accessibility effects on health
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DOI：
10.1136/jech.2003.013011
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发表时间：
2004-03-01
影响因子：
6.3
通讯作者：
Martin, D
中科院分区：
文献类型：
--
作者：
Jordan, H;Roderick, P;Martin, D
研究目的：调查2000年多重贫困指数（IMD）与农村地区健康不平等的关系是否比传统的贫困指数更密切。探索IMD领域“地理获取服务”对理解农村健康变化的贡献。设计：基于地理的横断面研究。设置：英格兰西南地区的九个县。参与者：所有在1991年人口普查中报告患有限制性长期疾病的65岁以下的人，以及所有在1991 - 1996年期间死亡的人，主要结果：IMD与汤森评分的总体相关性（r（2）= 0.44 v0.53）和发病率（r（2）= 0.79 v0.76）具有可比性。在农村地区，汤森评分与人口健康之间的相关性较弱，但IMD与发病率保持强相关性（r（2）= 0.70）。IMD的“地理可及服务”领域与农村地区的发病率没有强相关性（r（2）= 0.04），而在城市地区显示出负相关性（r（2）= 20.47）。结论：IMD与农村和城市地区的健康有很强的关系。这很可能是由于IMD中包含了与健康状况不佳和残疾相关的索赔人数数据。在农村地区，“获得服务的地理位置”领域与保健没有关联，尽管在城市地区显示出某种关联。这一领域具有潜在的重要性，但在IMD中尚未就健康研究的目的进行充分说明。
Study objective: To investigate whether the Index of Multiple Deprivation 2000 (IMD) is more strongly related to inequalities in health in rural areas than traditional deprivation indices. To explore the contribution of the IMD domain "geographical access to services'' to understanding rural health variations.Design: A geographically based cross sectional study.Setting: Nine counties in the south west region of England.Participants: All those aged below 65 who reported a limiting long term illness in the 1991 census, and all those who died during 1991 - 96, aged less than 65 years.Main results: The IMD is comparable with the Townsend score in its overall correlation with premature mortality (r(2) = 0.44 v 0.53) and morbidity (r(2) = 0.79 v 0.76). Correlation between the Townsend score and population health is weak in rural areas but the IMD maintains a strong correlation with rates of morbidity (r(2) = 0.70). The "geographical access to services'' domain of the IMD is not strongly correlated with rates of morbidity in rural areas (r(2) = 0.04), and in urban areas displays a negative correlation (r(2) = 20.47).Conclusions: The IMD has a strong relation with health in both rural and urban areas. This is likely to be the result of the inclusion of data in the IMD on the numbers of people claiming benefits related to ill health and disability. The domain "geographical access to services'' is not associated with health in rural areas, although it displays some association in urban areas. This domain is potentially important but, as yet, inadequately specified in the IMD for the purposes of health research.