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 UK Neighbourhood Statistics programme, a project to create a new Index of Multiple Deprivation for England (London example shown) was commissioned. This 'index' combines 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) was published in June 2004 and was updated in October 2006 with SIMD 2006 General Report. It is available at data zone level as an overall deprivation index and as separate indices for different domains. The SIMD 2006 contains 37 indicators in seven domains: Current Income, Employment, Health, Education Skills and Training, Geographic Access to Services (including public transport travel times for the first time), Housing and a new Crime domain. The SIMD is already widely used across local and national government for directing resources (see guidance on 'regeneration outcome agreements', ROAs), setting targets (Closing the Opportunity Gap) and monitoring social and health inequalities (the Scottish Executive's Social focus on deprived areas).

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, 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 Executive's approaches to tackling health inequalities, which focuses on alleviating deprivation and its impact on health. As an example, the 2005-2008 spending review targets aim to "reduce health inequalities by increasing the rate of improvement across a range of indicators for the most deprived communities by 15%, by 2008".

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.