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Deprivation measures

Deprivation scores can be ascribed to an area or population to give a picture of its social and economic status.

When using deprivation scores, it is important to ensure that the area score being looked at does not confound the outcome being looked at e.g. living in a deprived area does not necessarily make you unhealthier, however being unhealthy is part of the deprivation score. Ascribing an area’s characteristics to the individual can lead to ecological fallacy.

 

Individual indicators used in the UK

National statistics socio-economic classification (NSSEC)

In 2001 the National Statistics Socio-economic Classification (NS-SEC) replaced Social Class based on Occupation (SC, formerly Registrar General's Social Class) and Socio-economic Groups (SEG). The NS-SEC classifies people based on their job and level within that job and this classification is now used in all official statistics and surveys.

There are 8 broad employment categories with many sub-categories beneath (not shown) [9]:

 

Categories

1

Higher managerial and professional occupations

1.1 Employers in large organisations and higher managerial occupations

1.2 Higher professional occupations

2

Lower professional and higher technical occupations,  Lower managerial occupations, Higher supervisory occupations

3

Intermediate occupations

4

Employers in small organisations and own account workers

5

Lower supervisory and lower technical occupations

6

Semi-routine occupations

7

Routine occupations

8

Never worked and long-term unemployed, including full-time students, and occupations not stated or inadequately described

Source:

http://ons.gov.uk/ons/guide-method/classifications/current-standard-classifications/soc2010/soc2010-volume-3-ns-sec--rebased-on-soc2010--user-manual/index.html#1

 

Other individual markers of socio-economic status sometimes used in public health include: income, occupation, years of education, housing, ownership of various goods such as car, washing machine etc.

 

Summary of area indicators used in England
 

Deprivation score

Issued by and latest version

Domains

Pros

Cons

Index of Multiple Deprivation [10]

Issued by Department of Communities and Local Government- latest version 2015

Includes the dimensions- employment, income, health and disability, education skills and training, barriers to housing and services, crime and disorder, living environment, plus overall score.

Issued at LSOA level- can be aggregated by population-weighted averages. DCLG does this for LA’s.

Broad range of measures.

Cannot make direct comparisons between  2015 IMD and previous version because scores are calculated differently by year. Can only comment on relative rank differences between years.

Jarman score

 

Initially developed as a measure of GP workload.

Used to determine deprivation payments to GPs by DH. Carr-Hill formula now used to adjust global sum for GP practices by factors which affect workload.

 

(Used census data but has not been updated with 2011 census data from official sources)

Includes:

-% people in households aged >65 living alone,

-% people in households aged <5,

-1 person >16 plus 1 or more children <16,

-those >16 seeking work,

-persons in households with >1 person per room, -moved within last year, -households headed by new commonwealth /Pakistan.

Can be used for small areas.

Diverse range of measures.

Differences between wards are masked.

Data is linked to last census (2001) so can be out of date.

Does not indicate the proportion of people in an area who are deprived.

Biased towards urban population.

DETR 2000

Uses ward level indices from former Department of the environment, transport and the regions (DETR) 2000 combined with IMD 2000

 

(Not been updated with more recent data sources)

6 domains are:

- income

- employment

- health deprivation
  and disability

- education, skills and - training

- housing 

- geographical access
  to services

Data is updateable

Can distinguish between different aspects of deprivation.

Gives the proportion of people that are deprived for the income and employment domains.

 Some domains (housing) derived from only a few data sources.

Variables are weighted differently though justification is not clear.

Access score is more reflective of rural rather than urban need.

Data is not available below ward level.

District averages are applied to ward level in some instances.

Townsend Material Deprivation Score

Uses census data

 

(Not been updated with 2011 census data from official sources)

 

4 domains are:

- Unemployment: %
  economically active
  who are employed

- car ownership

- owner occupation

- overcrowding (>1
  person per room)

Can be used to look at small areas.

Highly correlated with measures of ill-health.

Easy to calculate because sum of standardised scores.

Data can be out of date as linked to last census- particularly in terms of housing tenure.

Does not indicate the proportion of people in an area who are deprived.

Better indicator of deprivation in urban areas that rural areas.

Carstairs

Uses census data

 

(Not been updated with 2011 census data from official sources)

4 domains are:

- Unemployment: %
  economically inactive
  males aged >16 who
  are employed

- % households
  without car
  ownership

- overcrowding (>1
  person per room)

  % residents in
  households with an
  economically active
  head of household in
  Social Class IV or V
  approximated from

  NS-SEC

Based on census so allow objective results for whole population.

Can be used to look at small areas.

For an outcome such as low birthweight, Carstairs scores have been

shown to perform better than individual social class in describing the

extent of inequalities in the population[9]

Data can be out of date as linked to last census- particularly in terms of housing tenure.

Better indicator of deprivation in urban areas that rural areas.

 

Many other countries around the world use additional indices of deprivation.

Deprivation indices can be ascribed to different geographical areas such as locality, ward or super output area (SOA)*.

*Super Output Areas (SOAs) are a geographic hierarchy designed to improve the reporting of small area statistics. Unlike electoral wards, SOA layers (lower, middle and upper) are of consistent size across the country and are not subjected to regular boundary change. In England, based on the 2011 census there are [11]:

  • 32,844 Lower Layer SOAs with a minimum population of 1000
  • 6,791 Middle Layer SOAs with a minimum population of 5000
  • Upper Layer SOAs have not been created as part of the 2011 census hierarchy.

SOAs are defined by 9 characters: The first character is either E for England or W for Wales. The next two characters are either 01 for Lower Layer, or 02 for Middle Layer and the remaining six characters make up the unique 6-digit tag for each zone.

 

References

 

 

                                                  © Rosalind Blackwood 2009, Claire Currie 2016