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Can a deprivation index be used legitimately over both urban and rural areas?

BACKGROUND: Although widely used, area-based deprivation indices remain sensitive to urban–rural differences as such indices are usually standardised around typical urban values. There is, therefore, a need to determine to what extent available deprivation indices can be used legitimately over both...

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Autores principales: Bertin, Mélanie, Chevrier, Cécile, Pelé, Fabienne, Serrano-Chavez, Tania, Cordier, Sylvaine, Viel, Jean-François
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063986/
https://www.ncbi.nlm.nih.gov/pubmed/24929662
http://dx.doi.org/10.1186/1476-072X-13-22
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author Bertin, Mélanie
Chevrier, Cécile
Pelé, Fabienne
Serrano-Chavez, Tania
Cordier, Sylvaine
Viel, Jean-François
author_facet Bertin, Mélanie
Chevrier, Cécile
Pelé, Fabienne
Serrano-Chavez, Tania
Cordier, Sylvaine
Viel, Jean-François
author_sort Bertin, Mélanie
collection PubMed
description BACKGROUND: Although widely used, area-based deprivation indices remain sensitive to urban–rural differences as such indices are usually standardised around typical urban values. There is, therefore, a need to determine to what extent available deprivation indices can be used legitimately over both urban and rural areas. METHODS: This study was carried out in Brittany, France, a relatively affluent region that contains deep rural areas. Among the 1,736 residential census block groups (IRIS) composing the Brittany region, 1,005 (57.9%) are rural. Four deprivation indices were calculated: two scores (Carstairs and Townsend) developed in the UK and two more recent French measures (Havard and Rey). Two standardisation levels were considered: all of the IRIS and only the urban IRIS of the region. Internal validity (Kappa coefficients and entropy values) and external validity (relationship with colorectal cancer screening [CCS] attendance) were investigated. RESULTS: Regardless of the deprivation measure used, wealthy areas are mostly clustered in the West and at the outskirts of major towns. Carstairs and Rey scores stand out by all evaluation criteria, capturing both urban and rural deprivation. High levels of agreements were found across standardisation levels (κ = 0.96). The distributions of deprivation scores were balanced across urban and rural areas, and high Shannon entropy values were observed in the capital city (≥0.93). Similar and significant negative trends were observed between CCS attendance and both deprivation indices, independent of the degree of urbanisation. CONCLUSIONS: These results provide support, despite potential sociological objections, for the use of a compromise index that would facilitate comparisons and interpretations across urban and rural locations in public health research.
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spelling pubmed-40639862014-06-21 Can a deprivation index be used legitimately over both urban and rural areas? Bertin, Mélanie Chevrier, Cécile Pelé, Fabienne Serrano-Chavez, Tania Cordier, Sylvaine Viel, Jean-François Int J Health Geogr Research BACKGROUND: Although widely used, area-based deprivation indices remain sensitive to urban–rural differences as such indices are usually standardised around typical urban values. There is, therefore, a need to determine to what extent available deprivation indices can be used legitimately over both urban and rural areas. METHODS: This study was carried out in Brittany, France, a relatively affluent region that contains deep rural areas. Among the 1,736 residential census block groups (IRIS) composing the Brittany region, 1,005 (57.9%) are rural. Four deprivation indices were calculated: two scores (Carstairs and Townsend) developed in the UK and two more recent French measures (Havard and Rey). Two standardisation levels were considered: all of the IRIS and only the urban IRIS of the region. Internal validity (Kappa coefficients and entropy values) and external validity (relationship with colorectal cancer screening [CCS] attendance) were investigated. RESULTS: Regardless of the deprivation measure used, wealthy areas are mostly clustered in the West and at the outskirts of major towns. Carstairs and Rey scores stand out by all evaluation criteria, capturing both urban and rural deprivation. High levels of agreements were found across standardisation levels (κ = 0.96). The distributions of deprivation scores were balanced across urban and rural areas, and high Shannon entropy values were observed in the capital city (≥0.93). Similar and significant negative trends were observed between CCS attendance and both deprivation indices, independent of the degree of urbanisation. CONCLUSIONS: These results provide support, despite potential sociological objections, for the use of a compromise index that would facilitate comparisons and interpretations across urban and rural locations in public health research. BioMed Central 2014-06-14 /pmc/articles/PMC4063986/ /pubmed/24929662 http://dx.doi.org/10.1186/1476-072X-13-22 Text en Copyright © 2014 Bertin et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Bertin, Mélanie
Chevrier, Cécile
Pelé, Fabienne
Serrano-Chavez, Tania
Cordier, Sylvaine
Viel, Jean-François
Can a deprivation index be used legitimately over both urban and rural areas?
title Can a deprivation index be used legitimately over both urban and rural areas?
title_full Can a deprivation index be used legitimately over both urban and rural areas?
title_fullStr Can a deprivation index be used legitimately over both urban and rural areas?
title_full_unstemmed Can a deprivation index be used legitimately over both urban and rural areas?
title_short Can a deprivation index be used legitimately over both urban and rural areas?
title_sort can a deprivation index be used legitimately over both urban and rural areas?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063986/
https://www.ncbi.nlm.nih.gov/pubmed/24929662
http://dx.doi.org/10.1186/1476-072X-13-22
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