Keywords
deprivation index, mortality, population census, Russia
Abstract
Background
Social and environmental inequalities in public health are recognized as global problems of our time. From the point of view of the theory of deprivation, social and environmental determinants identified as deprivation indicators, which help to detect health inequality. Indices are one of the most practical and powerful tools for measuring the level of deprivation.
Aim
The aims of our study are (1) to develop a Russian derivation index and (2) to analyze its associations with total and infant mortality.
Material and Methods
Deprivation indicators were obtained from the Federal State Statistics Service of Russia. All mortality data were taken from the official website of the Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation from 2009 to 2012. Principal components analysis with varimax rotation was used to (1) select suitable deprivation indicators and (2) create the index. A Spearman's correlation was run to determine the relationship of deprivation with all-cause and infant mortality. OLS regression was used to assess the relationship between deprivation and infant mortality.
Results
There is not a statistically significant correlation between deprivation and all-cause mortality. OLS regression showed a significant relationship between deprivation and infant mortality (p = 0.02). For every one-unit increase in the index score, infant mortality rate increases by about 7.4%.
Discussion
Our study showed that generally the most deprived regions were industrial with poor ecological conditions such as Chelyabinsk, Kurgan, Sverdlovsk, Tyumen, Omsk Oblasts, and Sakha and located in Ural and the Western Siberia.
References
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7. Chen R, Hu Z, Chen RL, Zhang D, Xu L, Wang J, Wei L. Socioeconomic deprivation and survival after stroke in China: a systematic literature review and a new population-based cohort study. BMJ Open 2015;5(1):e005688. doi: 10.1136/bmjopen-2014-005688.
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9. Woodward M, Peters SA, Batty GD, Ueshima H, Woo J, Giles GG, Barzi F, Ho SC, Huxley RR, Arima H, Fang X, Dobson A, Lam TH, Vathesatogkit P; Asia Pacific Cohort Studies Collaboration. Socioeconomic status in relation to cardiovascular disease and cause-specific mortality: a comparison of Asian and Australasian populations in a pooled analysis. BMJ Open 2015;5(3):e006408. doi: 10.1136/bmjopen-2014-006408.
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11. Ravaghi V, Durkan C, Jones K, Girdler R, Mair-Jenkins J, Davies G, Wilcox D, Dermont M, White S, Dailey Y, Morris AJ. Area-level deprivation and oral cancer in England 2012-2016. Cancer Epidemiol 2020;69:101840. doi: 10.1016/j.canep.2020.101840.
12. McQuarrie EP, Mackinnon B, Bell S, Fleming S, McNeice V, Stewart G, Fox JG, Geddes CC; Scottish Renal Biopsy Registry. Multiple socioeconomic deprivation and impact on survival in patients with primary glomerulonephritis. Clin Kidney J 2017;10(1):49-54. doi: 10.1093/ckj/sfw127.
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14. Dubikaytis T, Larivaara M, Kuznetsova O, Hemminki E. Inequalities in health and health service utilisation among reproductive age women in St. Petersburg, Russia: a cross-sectional study. BMC Health Serv Res 2010;10:307. doi: 10.1186/1472-6963-10-307.
15. Pampalon R, Hamel D, Gamache P, Simpson A, Philibert MD. Validation of a deprivation index for public health: a complex exercise illustrated by the Quebec index. Chronic Dis Inj Can 2014;34(1):12-22.
16. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health 2018;6:149. doi: 10.3389/fpubh.2018.00149.
17. Floyd, F. J., Widaman, K. F. Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment 1995;7(3):286–299. doi:10.1037/1040-3590.7.3.286
18. Kirkwood BR, Sterne JAC, Kirkwood BR. Essential medical statistics. Malden, Mass: Blackwell Science; 2003.
19. Hair JF, Tatham RL, Anderson RE, Black W. Multivariate data analysis. (Fifth Ed.) Prentice-Hall:London; 1998.
20. Stevens JP. Applied multivariate statistics for the social sciences (2nd edition). Hillsdale, NJ:Erlbaum; 1992.
21. Pallant J. SPSS survival manual : A step by step guide to data analysis using IBM SPSS (4th ed.). Crows Nest, NSW: Allen & Unwin; 2013.
22. Zhang X, Chen X, Gong W. Type 2 diabetes mellitus and neighborhood deprivation index: A spatial analysis in Zhejiang, China. J Diabetes Investig 2019;10(2):272-282. doi: 10.1111/jdi.12899.
23. Noble M, Wright G, Smith G, Dibben C. Measuring multiple deprivation at the small-area level. Environment and planning A 2006; 38(1): 169-185. doi:10.1068/a37168.
24. State of the environment and environmental protection in the Russian Federation in 2010. Annual State reports. [Russia] Available at: https://www.mnr.gov.ru/docs/gosudarstvennye_doklady/o_sostoyanii_i_ob_okhrane_okruzhayushchey_sredy_rossiyskoy_federatsii/. Accessed on 3/01/2022.
25. Choi MH, Cheong KS, Cho BM, Hwang IK, Kim CH, Kim MH, Hwang SS, Lim JH, Yoon TH. Deprivation and mortality at the town level in Busan, Korea: an ecological study. J Prev Med Public Health 2011;44(6):242-8. doi: 10.3961/jpmph.2011.44.6.242.
26. McCartney G, Popham F, Katikireddi SV, Walsh D, Schofield L. How do trends in mortality inequalities by deprivation and education in Scotland and England & Wales compare? A repeat cross-sectional study. BMJ Open 2017;7(7):e017590. doi: 10.1136/bmjopen-2017-017590.
27. Kraftman L, Hardelid P, Banks J. Age specific trends in mortality disparities by socio-economic deprivation in small geographical areas of England, 2002-2018: A retrospective registry study. Lancet Reg Health Eur 2021;7:100136. doi: 10.1016/j.lanepe.2021.100136.
28. Pearce JR, Richardson EA, Mitchell RJ, Shortt NK. Environmental justice and health: a study of multiple environmental deprivation and geographical inequalities in health in New Zealand. Soc Sci Med 2011;73(3):410-20. doi: 10.1016/j.socscimed.2011.05.039.
29. Yun JW, Kim YJ, Son M. Regional Deprivation Index and Socioeconomic Inequalities Related to Infant Deaths in Korea. J Korean Med Sci 2016;31(4):568-78. doi: 10.3346/jkms.2016.31.4.568.
30. Padilla CM, Kihal-Talantikit W, Vieira VM, Deguen S. City-Specific Spatiotemporal Infant and Neonatal Mortality Clusters: Links with Socioeconomic and Air Pollution Spatial Patterns in France. Int J Environ Res Public Health 2016;13(6):624. doi: 10.3390/ijerph13060624.
31. Guildea ZE, Fone DL, Dunstan FD, Sibert JR, Cartlidge PH. Social deprivation and the causes of stillbirth and infant mortality. Arch Dis Child 2001;84(4):307-10. doi: 10.1136/adc.84.4.307.
32. Genowska A, Jamiołkowski J, Szafraniec K, Stepaniak U, Szpak A, Pająk A. Environmental and socio-economic determinants of infant mortality in Poland: an ecological study. Environ Health 2015;14:61. doi: 10.1186/s12940-015-0048-1.
33. Greenland S. Ecologic versus individual-level sources of bias in ecologic estimates of contextual health effects. Int J Epidemiol 2001;30(6):1343-50. doi: 10.1093/ije/30.6.1343.
34. Nakaya T, Honjo K, Hanibuchi T, Ikeda A, Iso H, Inoue M, Sawada N, Tsugane S; Japan Public Health Center-based Prospective Study Group. Associations of all-cause mortality with census-based neighbourhood deprivation and population density in Japan: a multilevel survival analysis. PLoS One 2014;9(6):e97802. doi: 10.1371/journal.pone.0097802.
35. Calling S, Li X, Sundquist J, Sundquist K. Socioeconomic inequalities and infant mortality of 46,470 preterm infants born in Sweden between 1992 and 2006. Paediatr Perinat Epidemiol 2011;25(4):357-65. doi: 10.1111/j.1365-3016.2011.01200.x.
36. Research Organizing Committee of the ESSE-RF project Epidemiology of cardiovascular diseases in different regions of Russia (ESSE-RF). The rationale for and design of the study. Russ. J. Prev. Med. Public Health 2013;6:25–34. [Russia]
2. Regional Committee for Europe, 61st session. Sixty-first Regional Committee for Europe: Baku, 12–15 September 2011: interim second report on social determinants of health and the health divide in the WHO European Region. World Health Organization. Regional Office for Europe; 2011. Available at: https://apps.who.int/iris/handle/10665/336040 Accessed on 10/01/2022.
3. Prüss-Üstün A, Wolf J, Corvalán C, Bos R, Neira M. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. World Health Organization; 2016. Available at: https://www.who.int/publications/i/item/9789241565196. Accessed on 15/01/2022. Accessed on 10/01/2022.
4. WHO report on cancer: setting priorities, investing wisely and providing care for all. Geneva: World Health Organization; 2020. Available at: https://apps.who.int/iris/handle/10665/330745. Accessed on 10/01/2022.
5. Prüss-Üstün, Annette, Corvalán, Carlos F & World Health Organization. (2006). Preventing disease through healthy environments : towards an estimate of the environmental burden of disease / Prüss-Üstün A, Corvalán C. World Health Organization. Available at: https://apps.who.int/iris/handle/10665/43457. Accessed on 15/01/2022.
6. Pathirana TI, Jackson CA. Socioeconomic status and multimorbidity: a systematic review and meta-analysis. Aust N Z J Public Health 2018;42(2):186-194. doi: 10.1111/1753-6405.12762.
7. Chen R, Hu Z, Chen RL, Zhang D, Xu L, Wang J, Wei L. Socioeconomic deprivation and survival after stroke in China: a systematic literature review and a new population-based cohort study. BMJ Open 2015;5(1):e005688. doi: 10.1136/bmjopen-2014-005688.
8. Kim TJ, von dem Knesebeck O. Income and obesity: what is the direction of the relationship? A systematic review and meta-analysis. BMJ Open 2018;5;8(1):e019862. doi: 10.1136/bmjopen-2017-019862.
9. Woodward M, Peters SA, Batty GD, Ueshima H, Woo J, Giles GG, Barzi F, Ho SC, Huxley RR, Arima H, Fang X, Dobson A, Lam TH, Vathesatogkit P; Asia Pacific Cohort Studies Collaboration. Socioeconomic status in relation to cardiovascular disease and cause-specific mortality: a comparison of Asian and Australasian populations in a pooled analysis. BMJ Open 2015;5(3):e006408. doi: 10.1136/bmjopen-2014-006408.
10. Townsend P. Deprivation. Journal of Social Policy, 16(2), 125-146; 1987. doi:10.1017/S0047279400020341
11. Ravaghi V, Durkan C, Jones K, Girdler R, Mair-Jenkins J, Davies G, Wilcox D, Dermont M, White S, Dailey Y, Morris AJ. Area-level deprivation and oral cancer in England 2012-2016. Cancer Epidemiol 2020;69:101840. doi: 10.1016/j.canep.2020.101840.
12. McQuarrie EP, Mackinnon B, Bell S, Fleming S, McNeice V, Stewart G, Fox JG, Geddes CC; Scottish Renal Biopsy Registry. Multiple socioeconomic deprivation and impact on survival in patients with primary glomerulonephritis. Clin Kidney J 2017;10(1):49-54. doi: 10.1093/ckj/sfw127.
13. GBD 2016 Russia Collaborators. The burden of disease in Russia from 1980 to 2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2018;392(10153):1138-1146. doi: 10.1016/S0140-6736(18)31485-5.
14. Dubikaytis T, Larivaara M, Kuznetsova O, Hemminki E. Inequalities in health and health service utilisation among reproductive age women in St. Petersburg, Russia: a cross-sectional study. BMC Health Serv Res 2010;10:307. doi: 10.1186/1472-6963-10-307.
15. Pampalon R, Hamel D, Gamache P, Simpson A, Philibert MD. Validation of a deprivation index for public health: a complex exercise illustrated by the Quebec index. Chronic Dis Inj Can 2014;34(1):12-22.
16. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health 2018;6:149. doi: 10.3389/fpubh.2018.00149.
17. Floyd, F. J., Widaman, K. F. Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment 1995;7(3):286–299. doi:10.1037/1040-3590.7.3.286
18. Kirkwood BR, Sterne JAC, Kirkwood BR. Essential medical statistics. Malden, Mass: Blackwell Science; 2003.
19. Hair JF, Tatham RL, Anderson RE, Black W. Multivariate data analysis. (Fifth Ed.) Prentice-Hall:London; 1998.
20. Stevens JP. Applied multivariate statistics for the social sciences (2nd edition). Hillsdale, NJ:Erlbaum; 1992.
21. Pallant J. SPSS survival manual : A step by step guide to data analysis using IBM SPSS (4th ed.). Crows Nest, NSW: Allen & Unwin; 2013.
22. Zhang X, Chen X, Gong W. Type 2 diabetes mellitus and neighborhood deprivation index: A spatial analysis in Zhejiang, China. J Diabetes Investig 2019;10(2):272-282. doi: 10.1111/jdi.12899.
23. Noble M, Wright G, Smith G, Dibben C. Measuring multiple deprivation at the small-area level. Environment and planning A 2006; 38(1): 169-185. doi:10.1068/a37168.
24. State of the environment and environmental protection in the Russian Federation in 2010. Annual State reports. [Russia] Available at: https://www.mnr.gov.ru/docs/gosudarstvennye_doklady/o_sostoyanii_i_ob_okhrane_okruzhayushchey_sredy_rossiyskoy_federatsii/. Accessed on 3/01/2022.
25. Choi MH, Cheong KS, Cho BM, Hwang IK, Kim CH, Kim MH, Hwang SS, Lim JH, Yoon TH. Deprivation and mortality at the town level in Busan, Korea: an ecological study. J Prev Med Public Health 2011;44(6):242-8. doi: 10.3961/jpmph.2011.44.6.242.
26. McCartney G, Popham F, Katikireddi SV, Walsh D, Schofield L. How do trends in mortality inequalities by deprivation and education in Scotland and England & Wales compare? A repeat cross-sectional study. BMJ Open 2017;7(7):e017590. doi: 10.1136/bmjopen-2017-017590.
27. Kraftman L, Hardelid P, Banks J. Age specific trends in mortality disparities by socio-economic deprivation in small geographical areas of England, 2002-2018: A retrospective registry study. Lancet Reg Health Eur 2021;7:100136. doi: 10.1016/j.lanepe.2021.100136.
28. Pearce JR, Richardson EA, Mitchell RJ, Shortt NK. Environmental justice and health: a study of multiple environmental deprivation and geographical inequalities in health in New Zealand. Soc Sci Med 2011;73(3):410-20. doi: 10.1016/j.socscimed.2011.05.039.
29. Yun JW, Kim YJ, Son M. Regional Deprivation Index and Socioeconomic Inequalities Related to Infant Deaths in Korea. J Korean Med Sci 2016;31(4):568-78. doi: 10.3346/jkms.2016.31.4.568.
30. Padilla CM, Kihal-Talantikit W, Vieira VM, Deguen S. City-Specific Spatiotemporal Infant and Neonatal Mortality Clusters: Links with Socioeconomic and Air Pollution Spatial Patterns in France. Int J Environ Res Public Health 2016;13(6):624. doi: 10.3390/ijerph13060624.
31. Guildea ZE, Fone DL, Dunstan FD, Sibert JR, Cartlidge PH. Social deprivation and the causes of stillbirth and infant mortality. Arch Dis Child 2001;84(4):307-10. doi: 10.1136/adc.84.4.307.
32. Genowska A, Jamiołkowski J, Szafraniec K, Stepaniak U, Szpak A, Pająk A. Environmental and socio-economic determinants of infant mortality in Poland: an ecological study. Environ Health 2015;14:61. doi: 10.1186/s12940-015-0048-1.
33. Greenland S. Ecologic versus individual-level sources of bias in ecologic estimates of contextual health effects. Int J Epidemiol 2001;30(6):1343-50. doi: 10.1093/ije/30.6.1343.
34. Nakaya T, Honjo K, Hanibuchi T, Ikeda A, Iso H, Inoue M, Sawada N, Tsugane S; Japan Public Health Center-based Prospective Study Group. Associations of all-cause mortality with census-based neighbourhood deprivation and population density in Japan: a multilevel survival analysis. PLoS One 2014;9(6):e97802. doi: 10.1371/journal.pone.0097802.
35. Calling S, Li X, Sundquist J, Sundquist K. Socioeconomic inequalities and infant mortality of 46,470 preterm infants born in Sweden between 1992 and 2006. Paediatr Perinat Epidemiol 2011;25(4):357-65. doi: 10.1111/j.1365-3016.2011.01200.x.
36. Research Organizing Committee of the ESSE-RF project Epidemiology of cardiovascular diseases in different regions of Russia (ESSE-RF). The rationale for and design of the study. Russ. J. Prev. Med. Public Health 2013;6:25–34. [Russia]