Ribeiro Ana Isabel, Mayer Alexandra, Miranda Ana, Pina Maria Fátima
EPIUNIT - Instituto de Saúde Pública. Universidade do Porto. Porto. Portugal; Instituto de Investigação e Inovação em Saúde. Universidade do Porto. Porto. Portugal; Instituto de Engenharia Biomédica. Universidade do Porto. Porto. Portugal; Departamento de Epidemiologia Clínica. Medicina Preditiva e Saúde Pública. Faculdade de Medicina. Universidade do Porto. Porto. Portugal.
Registo Oncológico Regional Sul. Lisboa. Portugal.
Acta Med Port. 2017 Jan 31;30(1):17-25. doi: 10.20344/amp.7387.
Tackling socioeconomic health inequalities is a big public health challenge and ecological deprivation indexes are essential instruments to monitor and understand them. In Portugal, no standard ecological deprivation index exists, contrasting with other countries. We aimed to describe the construction of the Portuguese version of a transnational deprivation index, European Deprivation Index.
The European Deprivation Index was developed under the Townsend theorization of deprivation. Using data from the European Union - Statistics on Income and Living Conditions Survey, we obtained an indicator of individual deprivation. This indicator became the gold-standard variable, based on what we selected the variables at aggregate level (census) to be included in the European Deprivation Index, a total of eight. The European Deprivation Index was produced for the smallest area unit possible (n = 16 094, mean/area = 643 inhabitants) and resulted from the weighted sum of the previous variables. It was then classified into quintiles.
The first quintile (least deprived) comprised 20.9% national population and the fifth quintile (most deprived) 18.0%. The European Deprivation Index showed a clear geographic pattern - most deprived areas concentrated in the South and in the inner North and Centre of the country, and the least deprived areas in the coastal areas of North and Centre and in the Algarve.
The development of the European Deprivation Index was grounded on a solid theoretical framework, individual and aggregate variables, and on a longitudinal Europe-wide survey allowing its replication over the time and in any European country.
Hopefully, the European Deprivation Index will start being employed by those interested in better understand health inequalities not only in Portugal but across Europe.
应对社会经济健康不平等是一项重大的公共卫生挑战，而生态剥夺指数是监测和理解这些不平等现象的重要工具。与其他国家不同，葡萄牙不存在标准的生态剥夺指数。我们旨在描述跨国剥夺指数——欧洲剥夺指数葡萄牙版本的构建情况。
欧洲剥夺指数是在汤森剥夺理论的基础上制定的。利用欧盟收入和生活条件统计调查的数据，我们获得了个体剥夺指标。该指标成为了黄金标准变量，基于此我们在总体层面（人口普查）选择了纳入欧洲剥夺指数的变量，共计八个。欧洲剥夺指数是针对尽可能小的区域单位编制的（n = 16094，平均每个区域 = 643名居民），它是先前变量加权总和的结果。然后将其分为五个五分位数。
第一个五分位数（剥夺程度最低）包括20.9%的全国人口，第五个五分位数（剥夺程度最高）包括18.0%的全国人口。欧洲剥夺指数呈现出明显的地理格局——剥夺程度最高的地区集中在南部以及北部和中部的内陆地区，而剥夺程度最低的地区在北部和中部的沿海地区以及阿尔加维。
欧洲剥夺指数的编制基于坚实的理论框架、个体和总体变量，以及一项全欧洲范围的纵向调查，这使得该指数能够随时间推移在任何欧洲国家进行复制。
希望欧洲剥夺指数将开始被那些不仅对葡萄牙而且对整个欧洲更好地理解健康不平等感兴趣的人所采用。
