[Relevance and validity of a new French composite index to measure poverty on a geographical level].
BACKGROUND
A number of disease conditions are influenced by deprivation. Geographical measurement of deprivation can provide an independent contribution to individual measures by accounting for the social context. Such a geographical approach, based on deprivation indices, is classical in Great Britain but scarcely used in France. The objective of this work was to build and validate an index readily usable in French municipalities and cantons.


METHODS
Socioeconomic data (unemployment, occupations, housing specifications, income, etc.) were derived from the 1990 census of municipalities and cantons in the Doubs departement. A new index was built by principal components analysis on the municipality data. The validity of the new index was checked and tested for correlations with British deprivation indices.


RESULTS
Principal components analysis on municipality data identified four components (explaining 76% of the variance). Only the first component (CP1 explaining 42% of the variance) was retained. Content validity (wide choice of potential deprivation items, correlation between items and CP1: 0.52 to 0.96) and construct validity (CP1 socially relevant; Cronbach's alpha=0.91; correlation between CP1 and three out of four British indices ranging from 0.73 to 0.88) were sufficient. Analysis on canton data supported that on municipality data.


CONCLUSIONS
The validation of the new index being satisfactory, the user will have to make a choice. The new index, CP1, is closer to the local background and was derived from data from a French departement. It is therefore better adapted to more descriptive approaches such as health care planning. To examine the relationship between deprivation and health with a more etiological approach, the British indices (anteriority, international comparisons) would be more appropriate, but CP1, once validated in various health problem situations, should be most useful for French studies.
Département de Santé Publique, Faculté de Médecine et de Pharmacie de Besançon, 2 place St Jacques, 25030 Besançon Cedex. bruno.challier@ufc-chu-univ-fcomte.fr
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Challier
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Viel
D000704:Analysis of Variance; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005163:Factor Analysis, Statistical; D005191:Family Characteristics; D005602:France; D006285:Health Planning / Q000458:organization & administration; D006305:Health Status Indicators; D006798:Housing / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D009790:Occupations / Q000191:economics / Q000706:statistics & numerical data; D011203:Poverty / Q000191:economics* / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class; D014504:Urban Health / Q000706:statistics & numerical data