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 2013-2014, healthy life expectancy for those living in the 10% most deprived areas was 25.1 years lower for males and 22.1 years lower for females compared to those living in the 10% least deprived areas.

The publication of the Independent Inquiry into Inequalities in Health Report in 1998 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 and 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'.  A 1998 report by ISD Scotland,  Deprivation and health in Scotland (376 Kb), gives an overview of the situation in Scotland at that time.

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 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 and, because it is not reliant on Census data, can be updated on a more frequent basis.  English indices of deprivation were subsequently published for 2004, 2007 and 2015.

In Scotland, as part of the Scottish 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, 2009, 2012 and most recently in 2016. It is available at datazone level as an overall deprivation index and as separate indices for different domains. The SIMD 2016 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, setting targets (Scotland Performs) and monitoring social and health inequalities (see for example Long-Term Monitoring of Health Inequalities: Headline Indicators).

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.