Do standard measures of deprivation reflect health inequalities in older people?
The objective of the study is to examine the relationship between different deprivation indicators and both self-rated health and emergency admission rates of older people to determine which indicators best predict the health of people in this age group. The method employed an ecological study design using data from all 100 neighbourhoods in Sheffield in 2004 and analysing relationships in three age groups 50-64, 65-74 and over 75 years. Analysis was performed using Pearson correlation coefficient. For people aged 50-64 years, receipt of income support was the best predictor of poor self-reported health (R=0.85). For people aged 64-75 years, lack of formal educational qualifications showed the strongest relationship with poor health (R=0.88), although there was still a significantly strong relationship between poor self-rated health and both non-property ownership (R=0.8) and receipt of income support (R=0.7) in this age group. For people aged 75 years and over, lack of formal qualifications showed the strongest relationship (R=0.6, P<0.001). This was reinforced by a strong relationship between this indicator and emergency admission rates. In conclusion, caution should be used when using conventional deprivation/poverty measures to select older populations to be targeted for services. Our analysis has shown that the deprivation indicator that correlates best with the subjective health rating of people aged 75+ is educational qualification.
Alwan
Nisreen
N
Leeds Primary Care Trust, North West House, Ring Road, West Park, Leeds, UK. nisreen.alwan@nhs.net
Wilkinson
Margaret
M
Birks
Dorothy
D
Wright
John
J
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D004636:Emergency Service, Hospital; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D011203:Poverty; D011632:Public Assistance; D012959:Socioeconomic Factors; D006113:United Kingdom