Shin Hosung, Lee Suehyung, Chu Jang Min
Korea Institute for Health and Social Affairs, Seoul, Korea.
J Prev Med Public Health. 2009 Nov;42(6):392-402. doi: 10.3961/jpmph.2009.42.6.392.
The aims of this paper were to develop the composite deprivation index (CDI) for the sub-district (Eup-Myen-Dong) levels based on the theory of social exclusion and to explore the relationship between the CDI and the standardized mortality ratio (SMR).
The paper calculated the age adjusted SMR and we included five dimensions of social exclusion for CDI; unemployment, poverty, housing, labor and social network. The proxy variables of the five dimensions were the proportion of unemployed males, the percent of recipients receiving National Basic Livelihood Security Act benefits, the proportion of households under the minimum housing standard, the proportion of people with a low social class and the proportion of single-parent household. All the variables were standardized using geometric transformation and then we summed up them for a single index. The paper utilized the 2004-2006 National Death Registry data, the 2003-2006 national residents' registration data, the 2005 Population Census data and the 2005-2006 means-tested benefit recipients' data.
The figures were 115.6, 105.8 and 105.1 for the CDI of metropolitan areas (big cities), middle size cities and rural areas, respectively. The distributional variation of the CDI was the highest in metropolitan areas (8.9 - 353.7) and the lowest was in the rural areas (26.8 - 209.7). The extent and relative differences of deprivation increased with urbanization. Compared to the Townsend and Carstairs index, the CDI better represented the characteristics of rural deprivation. The correlation with the SMR was statistically significant and the direction of the CDI effects on the SMR was in accordance with that of the previous studies.
The study findings indicated mortality inequalities due to the difference in the CDI. Despite the attempt to improve deprivation measures, further research is warranted for the consensus development of a deprivation index.
本文旨在基于社会排斥理论开发适用于街道（邑 - 面 - 洞）层面的综合剥夺指数（CDI），并探讨CDI与标准化死亡率（SMR）之间的关系。
本文计算了年龄调整后的SMR，且纳入了用于CDI的社会排斥的五个维度；失业、贫困、住房、劳动力和社会网络。这五个维度的代理变量分别是失业男性比例、领取《国家基本生活保障法》福利的受助者百分比、低于最低住房标准的家庭比例、低社会阶层人群比例以及单亲家庭比例。所有变量均采用几何变换进行标准化，然后将它们相加得出一个单一指数。本文利用了2004 - 2006年国家死亡登记数据、2003 - 2006年全国居民登记数据、2005年人口普查数据以及2005 - 2006年经济状况调查福利受助者数据。
大城市、中等规模城市和农村地区的CDI数值分别为115.6、105.8和105.1。CDI的分布差异在大城市中最高（8.9 - 353.7），在农村地区最低（26.8 - 209.7）。剥夺的程度和相对差异随着城市化程度的提高而增加。与汤森指数和卡斯尔斯指数相比，CDI能更好地体现农村剥夺的特征。与SMR的相关性具有统计学意义，且CDI对SMR的影响方向与先前研究一致。
研究结果表明，由于CDI的差异导致了死亡率不平等。尽管试图改进剥夺测量方法，但仍有必要进行进一步研究以达成关于剥夺指数发展的共识。
