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Multiple deprivation index

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Map of deprivation in Northern Ireland
Deprivation in Northern Ireland is higher in Western and urban areas.

Indices of multiple deprivation (IMD) are datasets used within the UK to classify the relative deprivation (a measure of poverty) of small areas. Multiple components of deprivation are weighted with different strengths and compiled into a single score of deprivation.

The calculation and publication of the indices is devolved and indices of multiple deprivation for Wales, Scotland, England, and Northern Ireland are calculated separately. While the components of deprivation that make up the overall deprivation score are similar in all four nations of the UK the weights assigned to each component, the size of the geographies for which deprivation scores are calculated, and the years of calculation are different. As a result levels of deprivation cannot be easily compared between nations.

The geography at which IMDs are produced varies across the nations of the UK and has varied over time. Currently the smallest geography for which IMDs are published is LSOA level in both England and Wales, data zone level for Scotland, and Super Output Area (SOA) for Northern Ireland. Early versions of the English IMDs were published at electoral ward and English local authority level.

The use of IMDs in social analysis aims to balance the desire for a single number describing the concept of deprivation in a place and the recognition that deprivation has many interacting components. IMDs may be an improvement over simpler measures of deprivation such as low average household disposable income because they capture variables such as the advantage of access to a good school and the disadvantage of exposure to high levels of air pollution. A potential disadvantage is that the choice of components and the weighting of those components in the construction of the overall multiple deprivation score is unavoidably subjective.

Components of deprivation

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In the current English Indices of Deprivation 2019 (IoD2019) seven domains of deprivation are considered and weighted as follows,

  • Income. (22.5%)
  • Employment. (22.5%)
  • Education. (13.5%)
  • Health. (13.5%)
  • Crime. (9.3%)
  • Barriers to Housing and Services. (9.3%)
  • Living Environment. (9.3%)

These domains each have multiple components. For example the Barriers to Housing and Services considers seven components including levels of household overcrowding, homelessness, housing affordability, and the distance by road to four types of key amenity (post office, primary school, supermarket, and GP surgery).

Cases for indexes of multiple deprivation at larger and smaller geographies

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Maps of deprivation in Manchester using the English IMD decile on the left and the Manchester IMD decile on the right
In very deprived parts of England such as Manchester using English IMDs is often unhelpful as almost all of the local authority is very deprived. Using the raw deprivation scores to calculate a local IMD can be more useful when targeting local interventions.

IMDs are calculated separately for England, Wales, Scotland, and Northern Ireland and are not comparable across them. While the geographies, the input measures, and the weights assigned to each input measure are different in all four countries, they are similar enough to calculate a combined UK IMD with only small sacrifices in data quality. Decisions within the UK that are taken nationally would be usefully informed by a UK index of multiple deprivation and this work has been proven possible and performed.[1] The most recent whole-UK index of multiple deprivation was compiled by MySociety in 2021.[2]

There are also examples of IMDs being created for smaller geographies within nations. This is particularly important in places with very high deprivation in almost all areas. For example, using English IMDs in Manchester is not useful for targeting local interventions since over half of the city is classed as being in England's most deprived decile. By using raw deprivation scores before they are ranked, a local IMD can be calculated showing relative deprivation within a place instead of its relative deprivation within England.

Applicability of IMDs to the analysis of very diverse areas

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IMDs are the property of an area and of the average characteristics of the people living in that area. They are not the property of any single person living within the area. Failure by researchers to consider this can lead to misleading features in analysis based on IMDs. This is a particularly large risk in areas which are very diverse due to social housing and mixed community policies such as central London. In these settings, a mixed community with a mix of very low income families in poor health and very high income families in good health can return a middling IMD score that represents neither group well and fails to provide useful insight to users of analysis based on IMD data. Other groups not well represented by IMDs are mobile communities and people experiencing homelessness, some of the most deprived members of society.[3]

Responsibility for production

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Responsibility for the production of publication of IMDs varies by the nation that they cover. Northern Ireland Statistics and Research Agency (NISRA) publishes IMDs for Northern Ireland. StatsWales publishes IMDs for Wales. The Scottish Government publishes IMDs for Scotland. The UK Department for Levelling Up, Housing and Communities (DLUHC) publishes IMDs for England.

Early version of English IMDs were produced by the Social Disadvantage Research Group at the University of Oxford.

List of UK deprivation indexes

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The most recent IMDs for the four nations of the UK are,

Previous versions include,

Other deprivation indexes

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Other deprivation indexes, or similar indexes that measure properties of society linked to deprivation, are used for different analysis. Examples include,

Deprivation indexes in other countries

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Equivalents of IMDs outside of the UK include,

  • "Socio-Economic Indexes for Areas (SEIFA)". Australian Bureau of Statistics. 27 March 2018.
  • "Indice de défavorisation social" [The FDEP, The French DEPrivation index]. AtlaSanté (in French).
  • The European Deprivation Index[4]
  • "The Canadian Index of Multiple Deprivation". The Government of Canada. 12 June 2019.
  • China's county-level area deprivation index (CADI) [5]
  • The Swiss neighbourhood index of SEP (Swiss-SEP) [6][7]
  • The German Index of Multiple Deprivation (GIMD) [8]
  • The Italian deprivation index [9]
  • The Area Deprivation Index (ADI).[10][11] US Department of Health and Human Services. September 2022, developed by the U.S. Health Resources and Services Administration. The index is currently being used by the Centers for Medicare & Medicaid Services to adjust financial benchmarks in various Value-based health care models.[12] However, some researchers have pointed out that applying ADI in practice has several limitations.[13][14]
  • Social Deprivation Index[15][16] by the American Academy of Family Physicians
  • Social Vulnerability Index[17] by the U.S. Centers for Disease Control and Prevention

References

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  1. ^ Abel GA, Barclay ME, Payne RA (November 2016). "Adjusted indices of multiple deprivation to enable comparisons within and between constituent countries of the UK including an illustration using mortality rates". BMJ Open. 6 (11): e012750. doi:10.1136/bmjopen-2016-012750. PMC 5128942. PMID 27852716.
  2. ^ "Unified UK measures of rurality and deprivation". mySociety. 2021-04-22. Retrieved 2021-04-26.
  3. ^ Moscrop A, Ziebland S, Bloch G, Iraola JR (24 November 2020). "If social determinants of health are so important, shouldn't we ask patients about them?". BMJ. 371: m4150. doi:10.1136/bmj.m4150. PMID 33234506. S2CID 227128683.
  4. ^ Launoy G, Launay L, Dejardin O, Bryère J, Guillaume E (November 2018). "European Deprivation Index: designed to tackle socioeconomic inequalities in cancer in Europe". European Journal of Public Health. 28 (suppl_4): cky213-625. doi:10.1093/eurpub/cky213.625.
  5. ^ Wang Z, Chan KY, Poon AN, et al. (2021). "Construction of an area-deprivation index for 2869 counties in China: a census-based approach" (PDF). J Epidemiol Community Health. 75 (2): 114–119. doi:10.1136/jech-2020-214198. hdl:20.500.11820/b76c5efe-f4a2-4be2-bcbc-01ec5f34da47. PMID 33037046. S2CID 222256479.
  6. ^ Panczak R, Galobardes B, Voorpostel M, Spoerri A, Zwahlen M, Egger M (2012). "A Swiss neighbourhood index of socioeconomic position: development and association with mortality". J Epidemiol Community Health. 66 (12): 1129–36. doi:10.1136/jech-2011-200699. PMC 5204371. PMID 22717282.
  7. ^ Panczak R, Berlin C, Voorpostel M, Zwahlen M, Egger M (2023). "The Swiss neighbourhood index of socioeconomic position: update and re-validation". Swiss Med Wkly. 153 (1): 40028. doi:10.57187/smw.2023.40028. PMID 36652707. S2CID 255922171.
  8. ^ Maier W (2017). "[Indizes Multipler Deprivation zur Analyse regionaler Gesundheitsunterschiede in Deutschland : Erfahrungen aus Epidemiologie und Versorgungsforschung][Article in German]". Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 60 (12): 1403–12. doi:10.1007/s00103-017-2646-2. PMID 29119206.
  9. ^ Rosano A, Pacelli B, Zengarini N, Costa G, Cislaghi C, Caranci N (2020). "[Aggiornamento e revisione dell'indice di deprivazione italiano 2011 a livello di sezione di censimento][Article in Italian]". Epidemiol Prev. 44 (2–3): 162–70. doi:10.19191/EP20.2-3.P162.039. PMID 32631016.
  10. ^ "Neighborhood Atlas - Home". www.neighborhoodatlas.medicine.wisc.edu. Retrieved 2023-03-30.
  11. ^ "Landscape of Area-Level Deprivation Measures and Other Approaches to Account for Social Risk and Social Determinants of Health in Health Care Payments". ASPE. 26 September 2022. Retrieved 2023-03-30.
  12. ^ "Embedding Equity In Financial Benchmarks: Changes To The Health Equity Benchmark Adjustment". Health Affairs. Retrieved 2024-06-06.
  13. ^ "A Proposal to Enhance the Health Equity Benchmark Adjustment in ACO REACH". CareJourney Research Blog Article by Yubin Park, Aneesh Chopra et al. 16 September 2022. Retrieved 2024-06-06.
  14. ^ "Problem with the University of Wisconsin's Area Deprivation Index. And, no, face validity is not "the weakest of all possible arguments." by Andrew Gelman". Statistical Modeling, Causal Inference, and Social Science. Retrieved 2024-06-06.
  15. ^ "Social Deprivation Index(SDI)". ASPE. Retrieved 2024-06-06.
  16. ^ Butler D, Petterson S, Phillips R, Bazemore A (2013). "Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery". Health Serv. Res. 48 (2): 539–559. doi:10.1111/j.1475-6773.2012.01449.x. PMC 3626349. PMID 22816561.
  17. ^ "CDC/ASTDR Social Vulnerability Index". ASPE. 21 May 2024. Retrieved 2024-06-06.
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