Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality
Abstract Background The small-area deprivation indices are varied across countries due to different social context and data availability. Due to lack of chronic disease-related social deprivation index (SDI) in Hong Kong, China, this study aimed to develop a new SDI and examine its association with...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-021-01545-9 |
| _version_ | 1830408619612438528 |
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| author | Kailu Wang Chi-Kin Law Jiaying Zhao Alvin Yik-Kiu Hui Benjamin Hon-Kei Yip Eng Kiong Yeoh Roger Yat-Nork Chung |
| author_facet | Kailu Wang Chi-Kin Law Jiaying Zhao Alvin Yik-Kiu Hui Benjamin Hon-Kei Yip Eng Kiong Yeoh Roger Yat-Nork Chung |
| author_sort | Kailu Wang |
| collection | DOAJ |
| description | Abstract Background The small-area deprivation indices are varied across countries due to different social context and data availability. Due to lack of chronic disease-related social deprivation index (SDI) in Hong Kong, China, this study aimed to develop a new SDI and examine its association with cancer mortality. Methods A total of 14 socio-economic variables of 154 large Tertiary Planning Unit groups (LTPUGs) in Hong Kong were obtained from 2016 population by-census. LTPUG-specific all-cause and chronic condition-related mortality and chronic condition inpatient episodes were calculated as health outcomes. Association of socio-economic variables with health outcomes was estimated for variable selection. Candidates for SDI were constructed with selected socio-economic variables and tested for criterion validity using health outcomes. Ecological association between the selected SDI and cancer mortality were examined using zero-inflated negative binomial regression. Results A chronic disease-related SDI constructed by six area-level socio-economic variables was selected based on its criterion validity with health outcomes in Hong Kong. It was found that social deprivation was associated with higher cancer mortality during 2011–2016 (most deprived areas: incidence relative risk [IRR] = 1.40, 95% confidence interval [CI]: 1.27–1.55; second most deprived areas: IRR = 1.34, 95%CI: 1.21–1.48; least deprived areas as reference), and the cancer mortality gap became larger in more recent years. Excess cancer death related to social deprivation was found to have increased through 2011–2016. Conclusions Our newly developed SDI is a valid and routinely available measurement of social deprivation in small areas and is useful in resource allocation and policy-making for public health purpose in communities. There is a potential large improvement in cancer mortality by offering relevant policies and interventions to reduce health-related deprivation. Further studies can be done to design strategies to reduce the expanding health inequalities between more and less deprived areas. |
| first_indexed | 2024-12-20T18:55:19Z |
| format | Article |
| id | doaj.art-4f821f9ae11b4df4a062cfc31a69d22c |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-20T18:55:19Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-4f821f9ae11b4df4a062cfc31a69d22c2022-12-21T19:29:31ZengBMCInternational Journal for Equity in Health1475-92762021-09-0120111310.1186/s12939-021-01545-9Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortalityKailu Wang0Chi-Kin Law1Jiaying Zhao2Alvin Yik-Kiu Hui3Benjamin Hon-Kei Yip4Eng Kiong Yeoh5Roger Yat-Nork Chung6JC School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong KongNHMRC Clinical Trials Centre, University of SydneySchool of Demography, The Australian National UniversityJC School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong KongJC School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong KongJC School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong KongJC School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong KongAbstract Background The small-area deprivation indices are varied across countries due to different social context and data availability. Due to lack of chronic disease-related social deprivation index (SDI) in Hong Kong, China, this study aimed to develop a new SDI and examine its association with cancer mortality. Methods A total of 14 socio-economic variables of 154 large Tertiary Planning Unit groups (LTPUGs) in Hong Kong were obtained from 2016 population by-census. LTPUG-specific all-cause and chronic condition-related mortality and chronic condition inpatient episodes were calculated as health outcomes. Association of socio-economic variables with health outcomes was estimated for variable selection. Candidates for SDI were constructed with selected socio-economic variables and tested for criterion validity using health outcomes. Ecological association between the selected SDI and cancer mortality were examined using zero-inflated negative binomial regression. Results A chronic disease-related SDI constructed by six area-level socio-economic variables was selected based on its criterion validity with health outcomes in Hong Kong. It was found that social deprivation was associated with higher cancer mortality during 2011–2016 (most deprived areas: incidence relative risk [IRR] = 1.40, 95% confidence interval [CI]: 1.27–1.55; second most deprived areas: IRR = 1.34, 95%CI: 1.21–1.48; least deprived areas as reference), and the cancer mortality gap became larger in more recent years. Excess cancer death related to social deprivation was found to have increased through 2011–2016. Conclusions Our newly developed SDI is a valid and routinely available measurement of social deprivation in small areas and is useful in resource allocation and policy-making for public health purpose in communities. There is a potential large improvement in cancer mortality by offering relevant policies and interventions to reduce health-related deprivation. Further studies can be done to design strategies to reduce the expanding health inequalities between more and less deprived areas.https://doi.org/10.1186/s12939-021-01545-9DeprivationInequalitiesChronic diseaseCancerSmall area indices |
| spellingShingle | Kailu Wang Chi-Kin Law Jiaying Zhao Alvin Yik-Kiu Hui Benjamin Hon-Kei Yip Eng Kiong Yeoh Roger Yat-Nork Chung Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality International Journal for Equity in Health Deprivation Inequalities Chronic disease Cancer Small area indices |
| title | Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality |
| title_full | Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality |
| title_fullStr | Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality |
| title_full_unstemmed | Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality |
| title_short | Measuring health-related social deprivation in small areas: development of an index and examination of its association with cancer mortality |
| title_sort | measuring health related social deprivation in small areas development of an index and examination of its association with cancer mortality |
| topic | Deprivation Inequalities Chronic disease Cancer Small area indices |
| url | https://doi.org/10.1186/s12939-021-01545-9 |
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