title: Development of a cross-cultural deprivation index in five European countries.
abstract: BACKGROUND
  Despite a concerted policy effort in Europe, social inequalities in health are a persistent problem. Developing a standardised measure of socioeconomic level across Europe will improve the understanding of the underlying mechanisms and causes of inequalities. This will facilitate developing, implementing and assessing new and more effective policies, and will improve the comparability and reproducibility of health inequality studies among countries. This paper presents the extension of the European Deprivation Index (EDI), a standardised measure first developed in France, to four other European countries-Italy, Portugal, Spain and England, using available 2001 and 1999 national census data.
  
  
  RESULTS
  The method previously tested and validated to construct the French EDI was used: first, an individual indicator for relative deprivation was constructed, defined by the minimal number of unmet fundamental needs associated with both objective (income) poverty and subjective poverty. Second, variables available at both individual (European survey) and aggregate (census) levels were identified. Third, an ecological deprivation index was constructed by selecting the set of weighted variables from the second step that best correlated with the individual deprivation indicator.
  
  
  CONCLUSIONS
  For each country, the EDI is a weighted combination of aggregated variables from the national census that are most highly correlated with a country-specific individual deprivation indicator. This tool will improve both the historical and international comparability of studies, our understanding of the mechanisms underlying social inequalities in health and implementation of intervention to tackle social inequalities in health.
authors.affiliation: French Institute of Health and Medical Research-Caen University, U1086 "Cancers & Préventions", Caen, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Guillaume
authors.affiliation: French Institute of Health and Medical Research-Caen University, U1086 "Cancers & Préventions", Caen, France Pôle Recherche, University Hospital of Caen, Caen, France.
authors.forename: Carole
authors.identifier: http://orcid.org/0000-0001-9067-5076
authors.initials: C
authors.lastname: Pornet
authors.affiliation: French Institute of Health and Medical Research-Caen University, U1086 "Cancers & Préventions", Caen, France Pôle Recherche, University Hospital of Caen, Caen, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Dejardin
authors.affiliation: French Institute of Health and Medical Research-Caen University, U1086 "Cancers & Préventions", Caen, France Centre François Baclesse, Avenue du Général Harris-BP5026, Caen, France.
authors.forename: Ludivine
authors.initials: L
authors.lastname: Launay
authors.affiliation: Department of Sociology, PhD School in Applied Sociology and Methodology of Research, University of Milan-Bicocca, Genoa, Italy Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lillini
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Vercelli
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Agència de Salut Pública de Barcelona, Barcelona, Spain Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Marí-Dell'Olmo
authors.affiliation: Agència de Salut Pública de Barcelona, Barcelona, Spain.
authors.forename: Amanda
authors.initials: A
authors.lastname: Fernández Fontelo
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Agència de Salut Pública de Barcelona, Barcelona, Spain Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain Universitat Pompeu Fabra, Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.affiliation: Instituto de Engenharia Biomédica-INEB, Universidade do Porto-Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina do Porto, Universidade do Porto-Instituto de Saúde Pública da Universidade do Porto-ISPUP, Porto, Portugal.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Ribeiro
authors.affiliation: Instituto de Engenharia Biomédica-INEB, Universidade do Porto-Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina do Porto, Universidade do Porto-Instituto de Saúde Pública da Universidade do Porto-ISPUP, Porto, Portugal.
authors.forename: Maria Fatima de
authors.initials: MF
authors.lastname: Pina
authors.affiliation: Registro Oncologico Regional Sul, Lisbon, Portugal.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Mayer
authors.affiliation: INSERM, U1027, Toulouse F-31300, Toulouse, France Université Toulouse III Paul-Sabatier, UMR1027, Toulouse F-31300, Toulouse, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Delpierre
authors.affiliation: Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Bernard
authors.initials: B
authors.lastname: Rachet
authors.affiliation: French Institute of Health and Medical Research-Caen University, U1086 "Cancers & Préventions", Caen, France Pôle Recherche, University Hospital of Caen, Caen, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Launoy
mesh_terms: D000368:Aged; D003431:Cross-Cultural Comparison; D005060:Europe; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D011203:Poverty; D012044:Regression Analysis; D011795:Surveys and Questionnaires
keywords: DEPRIVATION; Health inequalities; Measurement tool Development; PUBLIC HEALTH; SOCIAL INEQUALITIES