Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

Development of Composite Deprivation Index for Korea: The Correlation with Standardized Mortality Ratio

표준화사망비와 지역결핍지수의 상관관계: 지역사회 통합결핍지수 개발

  • Published : 2009.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR). Methods : The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data. Results : The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies. Conclusions : The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.

Keywords

References

  1. Jarman B. Underprivileged areas: Validation and distribution of scores. Br Med J (Clin Res Ed) 1984; 289(6458): 1587-1592 https://doi.org/10.1136/bmj.289.6458.1587
  2. Townsend P, Phillimore P, Beattie A. Health and Deprivation: Inequalities and the North. New South Wales: Croom Helm; 1988
  3. Carstairs V, Morris R. Deprivation and Health in Scotland. Scotland: Aberdeen University Press; 1991
  4. Office of the Deputy Prime Minister. The English Indices of Deprivation 2004. West Yorkshire: Office of the Deputy Prime Minister; 2004. p. 1-180
  5. Salmond C, Crampton P. NZDep2001 Index of Deprivation. Wellington: Department of Public Health Wellington School of Medicine and Health Science; 2002. p. 1-60
  6. Pampalon R, Raymond G. A deprivation index for health and welfare planning in Quebec. Chronic Dis Can 2000; 21(3): 104-118
  7. Son M. The relationships of occupational class, educational level and deprivation with mortality in Korea. Korean J Prev Med 2002; 35(1): 76-82.(Korean)
  8. Jeong BG, Jung KY, Kim JY, Moon OR, Lee YH, Hong YS, et al. The relationship between regional material deprivation and the standardized mortality ratio of the community residents aged 15-64 in Korea. J Prev Med Public Health 2006; 39(1): 46-52. (Korean)
  9. Kim MH. A Multilevel Aanalysis on the Association between Socioeconomic Factors and the Metabolic Syndrome [dissertation]. Seoul: Hanyang University; 2002. (Korean)
  10. Lee SG. Social Contextual Effects on Regional Mortality and Self-rated Health Status [dissertation]. Seoul: Yonsei University; 2002. (Korean)
  11. Sim JH. The Relationship of Socioeconomic Status and Area based Deprivation on Cerebrovascular Mortality in Korea [dissertation]. Chuncheon: Kangwon National University; 2007. (Korean)
  12. Chu JM, Park JI, Cho MR, Choi SJ, Im JH, Shin HS, et al. Environmental Policy for Lowincome Population in Urban Area. Seoul: Korea Environment Institute; 2007. p. 106-109. (Korean)
  13. Kim MH, Subramanian SV, Kawachi I, Kim CY. Association between childhood fatal injuries and socioeconomic position at individual and area levels: A multilevel study. J Epidemiol Community Health 2007; 61(2): 135-140 https://doi.org/10.1136/jech.2006.047738
  14. Haynes R, Gale S. Deprivation and poor health in rural areas: Inequalities hidden by averages. Health Place 2000; 6(4): 275-285 https://doi.org/10.1016/S1353-8292(00)00009-5
  15. Jordan H, Roderick P, Martin D. The index of multiple deprivation 2000 and accessibility effects on health. J Epidemiol Community Health 2004; 58(3): 250-257 https://doi.org/10.1136/jech.2003.013011
  16. Moon JY. A comparative analysis of poverty regimes. Korean J Soc Welf 2005; 57(1): 245-269. (Korean)
  17. Kim AN, No DM, Kim MS, Shin HS, Kim TW, Kang MH, et al. A study of Support for the Socially Excluded toward Social Integration: The Dynamics and Multiple Dimensions of Social Exclusion. Seoul: Korea Institute for Health and Social Affairs; 2008. (Korean)
  18. Robinson P, Oppenheim C. Social Exclusion Indicators: A Submission to the Social exclusion Unit. London: Institute for Public Policy Research; 1998
  19. Burchardt T, Le Grand J, Piachaud D. Social Exclusion in Britain 1991~1995. Soc Policy Admin 1999; 33(3): 227-244 https://doi.org/10.1111/1467-9515.00148
  20. Bradshaw J. The relationship between poverty and social exclusion in Britain. [cited 2009 March 5] Available from: http://www.bris.ac.uk/poverty/pse/conf_pap/pol00_jrb.pdf
  21. Atkinson T, Cantillon B, Marlier E, Nolan B. Social Indicators: The EU and Social Inclusion. Oxford: Oxford University Press; 2002
  22. Hur MH, Sung YM. Contribution system of national health insurance: An empirical study on equity in a rural village. Korean Policy Stud Rev 2003; 12(1): 175-200. (Korean)
  23. Lee EW. Determinants and characteristics of rural poverty. Rural Econ Rev 2007; 30(4): 87-103. (Korean)
  24. Kim KS, Kim TH. Policy implication of minimum housing standard and the estimation of household sizes. Hum Settl 2008; 320: 96-107. (Korean)
  25. Kim AN, No DM, Kim MS, Shin HS, Kim TW, Kang MH, et al. A Study of Support for the Socially Excluded toward Social Integration, the Dynamics and Multiple Dimensions of Social Exclusion. Seoul: Korea Institute for Health and Social Affairs; 2008. (Korean)
  26. Townsend P, David N. Inequalities in Health: The Black Report. London: Pelican Books; 1982
  27. Kim KH, Lee KH, Lee SM, Lee SY, Lee YS, Lim KR, et al. The proportional mortality ratios of specific-cause mortality by occupation and education among men aged 20-64 in Korea (1993-2004). J Prev Med Public Health 2007; 40(1): 7-15. (Korean) https://doi.org/10.3961/jpmph.2007.40.1.7
  28. Kim HJ. A comparative study on the poverty trend and driving factors in welfare states. Korean J Soc Welf 2005; 57(1): 271-297. (Korean)
  29. Chung YS. Poverty type and status in single parents’household. [cited 2009 March 3]; Available from: http://www.riss4u.net/link?id=A76417545
  30. Kim MS, Won YH. The impact of self-control on the low-income single parents' psychological well-being. Korean Academy of Social Welfare Fall Conference Proceedings. 2003: 359-376. (Korean)
  31. Kim JH, Yoon TH. Comparisons of health inequalities in small areas with using the standardized mortality ratios in Korea. J Prev Med Public Health 2008; 41(5): 300-306. (Korean) https://doi.org/10.3961/jpmph.2008.41.5.300
  32. Stafford M, Marmot M. Neighbourhood deprivation and health: Does it affect us all equally? Int J Epidemiol 2003; 32(3): 357-366 https://doi.org/10.1093/ije/dyg084
  33. Smith GD, Hart C, Watt G, Hole D, Hawthorne V. Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: The Renfrew and Paisley study. J Epidemiol Community Health 1998; 52(6): 399-405 https://doi.org/10.1136/jech.52.6.399
  34. Morris R, Carstairs V. Which deprivation? A comparison of selected deprivation indexes. J Public Health Med 1991; 13(4): 318-326
  35. Khang YH, Lynch JW, Kaplan GA. Health inequalities in korea: Age- and sex-specific educational differences in the 10 leading causes of death. Int J Epidemiol 2004; 33(2): 299-308 https://doi.org/10.1093/ije/dyg244
  36. Min SG, Choi GH. Socioeconomic status of small scale farms and policy directions. J Rural Soc 1991; 1: 181-210. (Korean)
  37. Nakaya T. An information statistical approach to the modifiable areal unit problem in incidence rate maps. Environ Planning A 2000; 32(1): 91-109 https://doi.org/10.1068/a31145
  38. Armhein C. Searching for the elusive aggregation effect: Evidence from statistical simulations. Environ Planning A 1995; 27(1): 105-119 https://doi.org/10.1068/a270105
  39. Talbot RJ. Underprivileged areas and health care planning: Implications of use of Jarman indicators of urban deprivation. BMJ 1991; 302(6773): 383-386 https://doi.org/10.1136/bmj.302.6773.383
  40. Reijneveld SA, Verheij RA, de Bakker DH. The impact of area deprivation on differences in health: Does the choice of the geographical classification matter? J Epidemiol Community Health 2000; 54(4): 306-313 https://doi.org/10.1136/jech.54.4.306

Cited by

  1. 공간분석을 이용한 외래의료서비스 접근성 요인분석 vol.21, pp.1, 2009, https://doi.org/10.4332/kjhpa.2011.21.1.023
  2. 지역사회 보건사회지표를 이용한 시군구 지역 간 건강수준 비교 및 관련 요인 상관관계 분석 vol.23, pp.1, 2012, https://doi.org/10.12799/jkachn.2012.23.1.31
  3. 지역사회건강 연구와 근린의 사회경제적 수준 지표로서 주택 가격 수준의 이용 vol.21, pp.6, 2013, https://doi.org/10.12672/ksis.2013.21.6.081
  4. 기초자치단체의 폭염으로 인한 온열 및 심뇌혈관질환 부담 vol.31, pp.4, 2009, https://doi.org/10.14367/kjhep.2014.31.4.51
  5. Horizontal inequities in dental service utilization vol.39, pp.1, 2015, https://doi.org/10.11149/jkaoh.2015.39.1.9
  6. 지역 박탈수준과 중고령층의 활동제한의 연관성 vol.32, pp.2, 2015, https://doi.org/10.14367/kjhep.2015.32.2.27
  7. 지역사회 사망률 관련 요인에 대한 생태학적 연구 vol.32, pp.3, 2009, https://doi.org/10.14367/kjhep.2015.32.3.11
  8. Determinants of gastric cancer screening attendance in Korea: a multi-level analysis vol.15, pp.None, 2009, https://doi.org/10.1186/s12885-015-1328-4
  9. 치주질환이 심뇌혈관질환 발생에 미치는 영향: 지역결핍과 개인소득을 중심으로 vol.17, pp.4, 2009, https://doi.org/10.17135/jdhs.2017.17.4.375
  10. Regional Differences in Years of Life Lost in Korea from 1997 to 2015 vol.33, pp.53, 2009, https://doi.org/10.3346/jkms.2018.33.e330
  11. 서울특별시 사망률 변이 및 관련 특성 분석 vol.28, pp.1, 2009, https://doi.org/10.4332/kjhpa.2018.28.1.15
  12. Socioeconomic status and survival outcomes in elderly cancer patients: A national health insurance service‐elderly sample cohort study vol.8, pp.7, 2009, https://doi.org/10.1002/cam4.2231
  13. Use of the National Health Information Database for Estimating Town-Level Mortality in Korea: Comparison with the National Administrative Data, 2014-2017 vol.34, pp.23, 2009, https://doi.org/10.3346/jkms.2019.34.e168
  14. Measurement of Socioeconomic Position in Research on Cardiovascular Health Disparities in Korea: A Systematic Review vol.52, pp.5, 2009, https://doi.org/10.3961/jpmph.19.094
  15. Neighborhood Deprivation and Unmet Health Care Needs: A Multilevel Analysis of Older Individuals in South Korea vol.10, pp.5, 2009, https://doi.org/10.24171/j.phrp.2019.10.5.06
  16. Access to antenatal healthcare and the prevalence of oral clefts: a spatial analysis vol.128, pp.2, 2020, https://doi.org/10.1111/eos.12688
  17. Subnational Burden of Disease According to the Sociodemographic Index in South Korea vol.17, pp.16, 2009, https://doi.org/10.3390/ijerph17165788
  18. Development of the Korean Community Health Determinants Index (K-CHDI) vol.15, pp.10, 2009, https://doi.org/10.1371/journal.pone.0240304
  19. Assessment of Relative Asthma Risk in Populations Living near Incineration Facilities in Seoul, Korea vol.17, pp.20, 2009, https://doi.org/10.3390/ijerph17207448
  20. Comparison of three small-area mortality metrics according to urbanity in Korea: the standardized mortality ratio, comparative mortality figure, and life expectancy vol.18, pp.None, 2009, https://doi.org/10.1186/s12963-020-00210-7
  21. Do persons with low socioeconomic status have less access to greenspace? Application of accessibility index to urban parks in Seoul, South Korea vol.16, pp.8, 2009, https://doi.org/10.1088/1748-9326/ac12f1
  22. Spatial distribution of neighborhood-level housing prices and its association with all-cause mortality in Seoul, Korea (2013-2018): A spatial panel data analysis vol.16, pp.None, 2021, https://doi.org/10.1016/j.ssmph.2021.100963