Deprivation: introduction

The importance of deprivation as a key component of social inequality has been recognised for a long time. It is widely accepted that deprivation increases the risk of early death and is associated with higher rates of illness from certain diseases. For example, in relation to cardiovascular health, socioeconomic deprivation is associated with higher rates of admission to hospital and case fatality in heart failure.

The publication of the Independent Inquiry into Inequalities in Health Report in 1980 gave a new impetus to the study of the relationship between poverty and health. In the years following its publication, alternatives to social class - as a general measure of relative affluence or poverty in a society - were increasingly investigated such as unemployment and single parenthood. Several different ways of combining variables taken from the census or elsewhere were developed as a means of categorising deprivation within the populations of small geographically defined areas (census enumeration districts, local government wards, or postcode sectors). The methods in most common use until recently were those developed by Townsend et al, Jarman, Carstairs and Morris.  All use methods of combining variables to generate a summary score to reflect the socioeconomic status of a locality relative to the distribution of scores obtained for all localities. For more information on the relative merits of these particular measures see 'Which deprivation? A comparison of selected deprivation indexes'.

In 2000 as part of the Neighbourhood Statistics programme in England and Wales, a project to create a new Index of Multiple Deprivation for England (London example shown) was commissioned. This 'index' combined information relating to income, employment, education, health, skills and training, barriers to housing and services and crime into an overall measure of deprivation at a small area level. One of the key differences between this type of index and previous deprivation measures is that it is derived from administrative data, is not reliant on Census data and so can be updated on a more frequent basis.

In Scotland, as part of the Executive's Scottish Neighbourhood Statistics initiative, a new Scottish Index of Multiple Deprivation (SIMD) using similar methodology was published in June 2004 and was updated in 2006 and most recently in 2009. It is available at datazone level as an overall deprivation index and as separate indices for different domains. The SIMD 2009 contains 38 indicators in seven domains: Current Income, Employment, Health, Education Skills and Training, Geographic Access to Services (including public transport travel times), Housing and Crime. The SIMD is widely used across local and national government for directing resources (see for example the Fairer Scotland Fund), setting targets (Scotland Performs) and monitoring social and health inequalities (see Social focus on deprived areas).  However, it is important to note that only the employment domain is directly comparable between SIMD 2006 and SIMD 2009, due to changes in methodology and improvments in indicators and data sources. The next update to the SIMD is planned for 2012.

In relation to health, measures of deprivation are used for a variety of purposes, including: measuring and monitoring inequalities in health, access to healthcare and healthcare activity; and for standardising health and healthcare activity measures to enable more meaningful comparisons between organisations or geographical areas.

There are clearly many links between deprivation and health inequalities. The section on health inequalities summarises the Scottish Government's approach to tackling health inequalities, which focuses on alleviating deprivation and its impact on health. The data pages of this section provide a selection of charts highlighting associations between health and deprivation, while the key data sources section describes useful sources of deprivation data.