How Other Countries Use Deprivation Indices-And Why The United States Desperately Needs One.
Integrating public health and medicine to address social determinants of health is essential to achieving the Triple Aim of lower costs, improved care, and population health. There is intense interest in the United States in using social determinants of health to direct clinical and community health interventions, and to adjust quality measures and payments. The United Kingdom and New Zealand use data representing aspects of material and social deprivation from their censuses or from administrative data sets to construct indices designed to measure socioeconomic variation across communities, assess community needs, inform research, adjust clinical funding, allocate community resources, and determine policy impact. Indices provide these countries with comparable data and serve as a universal language and tool set to define organizing principles for population health. In this article we examine how these countries develop, validate, and operationalize their indices; explore their use in policy; and propose the development of a similar deprivation index for the United States.
Robert L. Phillips is vice president for research and policy at the American Board of Family Medicine, in Washington, D.C.
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Winston Liaw (wliaw@aafp.org) is medical director at the Washington, D.C., office of the American Academy of Family Physicians.
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Liaw
Peter Crampton is pro-vice-chancellor of the Division of Health Sciences, University of Otago, in Dunedin, New Zealand.
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Daniel J. Exeter is a senior lecturer at the University of Auckland, in New Zealand.
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Andrew Bazemore is director of the Robert Graham Center at the American Academy of Family Physicians.
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Katherine Diaz Vickery is a clinician investigator at Hennepin County Medical Center, in Minneapolis, Minnesota.
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Stephen Petterson is research director at the American Academy of Family Physicians.
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Mark Carrozza is director of HealthLandscape, in Cincinnati, Ohio.
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D019352:Censuses; D005102:Health Expenditures; D006301:Health Services Needs and Demand; D006801:Humans; D009520:New Zealand; D000075485:Population Health; D011634:Public Health; D040841:Resource Allocation / Q000458:organization & administration; D012959:Socioeconomic Factors; D006113:United Kingdom; D014481:United States
Determinants Of Health; International/global health studies; Public Health