Valerio M, Vitullo F
Laboratorio di salute pubblica e politiche sanitarie, Dipartimento di farmacologia clinica ed epidemiologia, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti.
Epidemiol Prev. 2000 Sep-Oct;24(5):219-23.
Deprivation measures have become important tools, in microarea and small area studies, both for examining variations in health and health care, and for planning services and allocating resources. To value the level of municipal deprivation in Basilicata (Southern Italy), 1991 Census data were used. As a first analytic step, variables selected as deprivation measures were calculated. "Elderly" variable was included at the first step since it was considered as an indicator of social burden and need. As a second analytic step, factorial analysis was performed in order to help in selecting the most valuable ones. The final choice led to five variables (elderly, low education, unemployment, no indoor bathroom, lone parent with children) which were combined in an Index of Deprived Area (IAS). The IAS showed a variation between -5.4 and 7.4. To validate the IAS, the municipal level of income was used: the index increased with decreasing income (r = -0.5). Municipalities were then ranked according to their IAS (decreasing) and divided into five deprivation categories, with about equal population number in each group. After excluding the "elderly" indicator, the ranking order showed irrelevant changes (modified IAS). Overall, the IAS seemed to well describe the difference among Municipalities, particularly between the first quintile (54 small towns with high prevalence of old people) and the last group (the urban area of the region). The developed tool and the obtained results may be used by administrators and health/social workers and professionals in charge of the Regional Epidemiological Observatory to improve the selection of health and social indicators for Local Health Authorities and Municipalities.
在微观区域和小区域研究中,贫困测量已成为重要工具,可用于考察健康与医疗保健方面的差异,以及规划服务和分配资源。为评估巴西利卡塔(意大利南部)的市级贫困水平,使用了1991年人口普查数据。作为第一步分析,计算了选定为贫困测量指标的变量。第一步纳入了“老年人”变量,因为它被视为社会负担和需求的一个指标。作为第二步分析,进行了因子分析,以帮助选择最有价值的变量。最终选择了五个变量(老年人、低教育程度、失业、无室内浴室、有子女的单亲家庭),将它们组合成一个贫困地区指数(IAS)。IAS显示的范围在-5.4至7.4之间。为验证IAS,使用了市级收入水平:该指数随收入降低而上升(r = -0.5)。然后根据各市政府的IAS(降序)进行排名,并分为五个贫困类别,每组人口数量大致相等。排除“老年人”指标后,排名顺序显示变化不大(修正后的IAS)。总体而言,IAS似乎能很好地描述各市政府之间的差异,特别是第一五分位数(54个老年人患病率高的小镇)和最后一组(该地区的市区)之间的差异。地方卫生当局和市政府的行政人员、卫生/社会工作者以及负责区域流行病学观察站的专业人员可使用所开发的工具和获得的结果,以改进健康和社会指标的选择。