A comparison of small-area deprivation indicators for public-health surveillance in Sweden

• Aims: 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 statistikomraden), each with a population size between 653 and 4243 at the end of 2018. Methods: 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. Results: 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. Conclusions: 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

Factor analysis

mortality

spatial smoothing

small-area

characteristics

sociodemographic factors

Sweden

index

Public

Environmental & Occupational Health

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)