Assessment of the ecological bias of seven aggregate social deprivation indices

Josephine Bryere,Thierry Lang,Olivier Dejardin,Carole Pornet,Pascale Grosclaude,Nane Copin,Guy Launoy,Olivier Lantieri,Ludivine Launay,Gaëlle Gusto,Cyrille Delpierre

doi:10.1186/s12889-016-4007-8

Abstract

BackgroundIn aggregate studies, ecological indices are used to study the influence of socioeconomic status on health. Their main limitation is ecological bias. This study assesses the misclassification of individual socioeconomic status in seven ecological indices.MethodsIndividual socioeconomic data for a random sample of 10,000 persons came from periodic health examinations conducted in 2006 in 11 French departments. Geographical data came from the 2007 census at the lowest geographical level available in France. The Receiver Operating Characteristics (ROC) curves, the areas under the curves (AUC) for each individual variable, and the distribution of deprived and non-deprived persons in quintiles of each aggregate score were analyzed.ResultsThe aggregate indices studied are quite good “proxies” for individual deprivation (AUC close to 0.7), and they have similar performance. The indices are more efficient at measuring individual income than education or occupational category and are suitable for measuring of deprivation but not affluence.ConclusionsThe study inventoried the aggregate indices available in France and evaluated their assessment of individual SES.

Highlights

In aggregate studies, ecological indices are used to study the influence of socioeconomic status on health
The overall objective of this study was to assess the ecological bias induced by using seven deprivation indices that evaluate deprivation at the lowest geographical unit level for which census data are available in France: Townsend index [3], Carstairs index [8], Lasbeur index [14], Havard index [15], European Deprivation index (EDI) [18], and the social (SCP) and material (MCP) components of Pampalon index [12, 22]
Ecological bias was assessed by comparing the deprivation level of the Areas grouped for statistical information (IRIS) with the individual level socioeconomic characteristics

Summary

Introduction

Ecological indices are used to study the influence of socioeconomic status on health. This study assesses the misclassification of individual socioeconomic status in seven ecological indices. Various approaches are used to measure socioeconomic status (SES). SES is mainly explored in three domains: income, education and occupational status [1]. Publicly available measures of SES in residential areas are frequently used [2]. As described by Townsend, deprivation, a “state of observable and demonstrable disadvantage relative to the local community or the wider society to which an individual, family or group belongs”, is a broad multidimensional concept that is closely linked to poverty.

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Conclusion