Deprivation indices: Their interpretation and use in relation to health
Deprivation indices: Their interpretation and use in relation to health
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DOI：
10.1136/jech.49.suppl_2.s3
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发表时间：
1995-12-01
影响因子：
6.3
通讯作者：
Carstairs, V
中科院分区：
文献类型：
--
作者：
Carstairs, V
研究目标 - 检查与健康相关的剥夺指数的使用。设计 - 本文回顾了精选的出版物，这些出版物说明了过去十年剥夺指数使用的多样性。这项工作的大部分基于该国现有的主要常规数据库：人口普查、人口、死亡率、癌症登记和卫生服务记录现在都包含邮政编码标识符，该标识符允许在小区域级别导出数据，从而检查与该区域（通常是病区或邮政编码部门）特征相关的健康事件。小区域方法为贫困和其他检查环境对健康影响的流行病学研究提供了宝贵的工具。背景 - 背景是各种期刊和官方出版物。主要结果 - 贫困与健康之间的联系已在许多研究中得到明确证明，生活在贫困地区的人口的死亡率水平，特别是 65 岁以下的人口，远远超过富裕地区的人口。 1981-91 年间，苏格兰和北部卫生区的这些差异有所扩大，健康方面的不平等现象有所扩大。分析表明，特定的死亡原因和癌症部位更可能反映社会经济因素的影响。迄今为止的工作主要显示了这些因素与健康措施之间的关联，需要对健康的决定因素进行更多调查，这些因素可能存在于过去和当前的情况下。事实证明，在旨在确定自然环境对生活在可能有害的工业过程附近的人口的影响的研究中，剥夺措施对于排除疾病发病率的可能变化是有价值的。卫生部已采用剥夺措施，作为向居住在这些地区的患者的全科医生增加支付的基础，但向地区当局分配资金的资源分配公式未能将这种措施纳入公式中。结论 - 地区剥夺措施已被证明是检查健康和死亡差异的宝贵工具，并且可能证明对卫生当局在规划医疗保健提供方面具有持续价值。未来的工作应努力研究健康的决定因素及其关联，尽管通过迄今为止为分析提供主要基础的常规数据库不太可能实现这一点。
Study objective - To examine the use of deprivation indices in relation to health.Design - This paper reviews selected publications which illustrate the diversity of use of deprivation indices in the past decade. Most of this work is based in the major routine databases which exist in this country: the census, population, mortality, cancer register, and health service records all now incorporate a postcode identifier which permits the derivation of data at small area level, and thus the examination of health events in relation to the characteristics of that area - usually ward or postcode sector. The small area approach provides a valuable tool both in deprivation and in other epidemiological studies which examine the influence of the environment on health.Setting - The setting is various journals and official publications.Main results - The link between deprivation and health has been clearly demonstrated in a number of studies, with populations living in deprived areas exhibiting levels of mortality, particularly below the age of 65, which vastly exceed those in affluent areas. In the decade 1981-91, these differentials increased in Scotland and the Northern Health Region and inequalities in health are shown to have widened. Analysis shows that particular causes of death and sites of cancer are more likely to reflect the influence of socioeconomic factors. The work so far mostly shows the associations between these factors and health measures and more investigation is required into the determinants of health, which are likely to reside as much in past as in current circumstances. A measure of deprivation has proved of value in excluding the likely variation in the incidence of disease in studies directed towards determining the influence of the physical environment on populations living in the vicinity of possible harmful industrial processes. A deprivation measure has been adopted by the Department of Health as a basis for making enhanced payments to general practitioners for patients living in these areas, but the resource allocation formula for allocating funds to regional authorities has failed to incorporate such a measure in the formula.Conclusions - An area measure of deprivation has proved a valuable tool in examining differentials in health and death and is likely to prove of continuing value to health authorities in planning the delivery of health care. Future work should strive to examine the determinants of health as well as the associations, although this is unlikely to be possible through the routine databases which have provided the main basis for analysis so far.