College of Social Sciences, University of Glasgow, 40 Bute Gardens, Glasgow G12 8RT, UK.
NHS Tayside Directorate of Public Health, King's Cross, Clepington Rd, Dundee DD3 8EA, UK.
Public Health. 2023 Apr;217:22-25. doi: 10.1016/j.puhe.2023.01.020. Epub 2023 Feb 24.
Area-based deprivation indices are used in many countries to target interventions and policies to populations with the greatest needs. Analyses of the Carstairs deprivation index applied to postcode sectors in 2001 identified that less than half of all deprived individuals lived in the most deprived areas.
This article examines the specificity and sensitivity of deprivation indices across Great Britain in identifying individuals claiming income- and employment-related social security benefits.
This was a descriptive analysis of cross-sectional administrative data.
The data sets for the 2020 Scottish Index of Multiple Deprivation, Scottish Income and Employment Index, the 2019 English Index of Multiple Deprivation and the 2019 Welsh Index of Multiple Deprivation were obtained. For each data set, small areas were ranked by increasing overall deprivation, and the cumulative proportions of individuals who were income and employment deprived were calculated. Receiver operating characteristic curves were plotted to show the sensitivity and specificity of each index, and the percentages of income- and employment-deprived individuals captured at different overall deprivation thresholds were calculated.
Across all indices, the sensitivity and specificity for detecting income- and employment-deprived individuals were low, with less than half living in the most deprived 20% of areas. Between 55% and 62% of income-deprived people and between 56% and 63% of employment-deprived people were missed across the indices at the 20% deprivation threshold. The sensitivity and specificity were slightly higher for income deprivation than employment deprivation across indices and slightly higher for the Scottish Index of Multiple Deprivation and Scottish Income and Employment Index than for the English Index of Multiple Deprivation and Welsh Index of Multiple Deprivation.
Area-based deprivation measures in Great Britain have limited sensitivity and specificity for identifying individuals who are income or employment deprived. Place-based policies and interventions are unlikely to be effective at reducing inequalities as a result. Creation of individually linked data sets and interventions that recognise the social and economic relationships between social groups are likely to be more effective.
许多国家都使用基于区域的贫困指数来针对最有需要的人群实施干预措施和政策。对 2001 年邮区划分部门应用卡斯特斯贫困指数的分析表明，不到一半的贫困人口生活在最贫困的地区。
本文旨在检验英国各地的贫困指数在识别申领收入和就业相关社会保障福利的个人方面的特异性和敏感性。
这是一项对横断面行政数据的描述性分析。
获取了 2020 年苏格兰多维度贫困指数、苏格兰收入和就业指数、2019 年英格兰多维度贫困指数和 2019 年威尔士多维度贫困指数的数据集。对于每个数据集，通过按总体贫困程度递增的顺序对小区域进行排序，并计算出收入和就业贫困者的累积比例。绘制受试者工作特征曲线以显示每个指数的敏感性和特异性，并计算出在不同总体贫困阈值下捕获的收入和就业贫困个体的百分比。
在所有指数中，检测收入和就业贫困个体的敏感性和特异性均较低，不到一半的人生活在最贫困的 20%的地区。在 20%的贫困阈值下，所有指数都遗漏了 55%至 62%的收入贫困者和 56%至 63%的就业贫困者。与就业贫困相比，收入贫困在各指数中的敏感性和特异性略高，苏格兰多维度贫困指数和苏格兰收入和就业指数的敏感性和特异性略高于英格兰多维度贫困指数和威尔士多维度贫困指数。
英国基于区域的贫困衡量标准在识别收入或就业贫困的个体方面的敏感性和特异性有限。因此，基于地点的政策和干预措施不太可能有效减少不平等现象。创建个人关联数据集和干预措施，认识到社会群体之间的社会和经济关系，可能会更有效。
