Abstract
The aims of this study were to construct a small-area index of multiple deprivation (IMD) from single deprivation indicators (SDIs) and to compare the explanatory power of the IMD and SDIs with regard to mortality. We considered a small-area division of Sweden consisting of 5985 DeSO (Demografiska statistikområden), each with a population size between 653 and 4243 at the end of 2018. Four SDIs were provided by open-source data: (a) the proportion of inhabitants with a low economic standard; (b) the proportion of inhabitants aged 25-64 years with ⩽12 years of schooling; (c) the proportion of inhabitants aged 16-64 years who were not in paid employment; and (d) the proportion of inhabitants who lived in a rented apartment/house. A four-indicator IMD was constructed using factor analysis. As a validation, the IMD and SDIs were compared by exploring their DeSO-level associations with spatially smoothed death rates, with robustness checks of associations across different small-area contexts defined by degree of urbanisation and distribution of immigrants from non-Western countries. The constructed IMD and SDI1 performed essentially equally and outperformed SDI2, SDI3 and SDI4. Associations between IMD/SDI1 and the spatially smoothed death rates were most pronounced within the age range 60-79 years, showing 5-8% lowered rates among those categorised in the least deprived quintiles of IMD and SDI1, respectively, and 7-9% elevated rates among those categorised in the most deprived quintiles. These associations were consistent within each small-area context. We suggest prioritisation of SDI1, that is, a DeSO-level deprivation indicator based on open-access data on economic standard, for public-health surveillance in Sweden.
Highlights
Indicators of small-area deprivation and corresponding indices of multiple deprivation (IMD) can represent useful proxies covering various domains, such as income, education, employment and housing [1]
A four-indicator IMD was formed as a single latent variable, with (a) an acceptable Kaiser–Meyer– Olkin (KMO) value of 0.53; (b) p
Segregation is more pronounced in urban areas, and neighbourhoods in Q1 and Q5 are relatively more frequent in urban than rural areas
Summary
Indicators of small-area deprivation and corresponding indices of multiple deprivation (IMD) can represent useful proxies covering various domains, such as income, education, employment and housing [1]. Date received 22 March 2021; reviewed 18 May 2021; accepted 15 June 2021. They are commonly used in the UK [4,5,6,7,8] and have been created for several other countries [2,9,10,11,12]. A Swedish index based on a geographical division referred to as SAMS (Small Areas for Market Statistics) was constructed for a study of neighbourhood deprivation influence on adolescent violent criminality and substance misuse, but only for SAMS in the three largest cities that had at least 500 inhabitants [13]. At the end of 2018, the population sizes across the 5985 DeSO varied between 653 and 4243
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