title: Adjusted indices of multiple deprivation to enable comparisons within and between constituent countries of the UK including an illustration using mortality rates.
abstract: Social determinants can have a major impact on health and as a consequence substantial inequalities are seen between and within countries. The study of inequalities between countries relies on having accurate and consistent measures of deprivation across the country borders. However, in the UK most socioeconomic deprivation measures are not comparable between countries. We give a method of adjusting the Indices of Multiple Deprivation (IMD) for use across the UK, describe the deprivation of each UK country, and show the problems introduced by naïvely using country-specific deprivation measures in a UK-wide analysis of mortality rates.
  
  
  
  42 148 geographic areas covering the population of the UK.
  
  
  
  Adjusted IMD scores based on the income and employment domains of country-specific IMD scores, adjusting for the contribution of other domains. The mortality rate among people aged under 75 years standardised to the UK age structure was compared between country-specific and UK-adjusted IMD quintiles.
  
  
  
  Of the constituent countries of the UK, Northern Ireland was the most deprived with 37% of the population living in areas in the most deprived fifth of the UK, followed by Wales with 22% of the population living in the most deprived fifth of the UK. England and Scotland had similar levels of deprivation. Deprivation-specific mortality rates were similar in England and Wales. Northern Ireland had lower mortality rates than England for each deprivation group, with similar differences for each group. Scotland had higher mortality rates than England for each deprivation group, with larger differences for more deprived groups.
  
  
  
  Analyses of between-country and within-country inequalities by socioeconomic position should use consistent measures; failing to use consistent measures may give misleading results. The published adjusted IMD scores we describe allow consistent analysis across the UK.
authors.affiliation: University of Exeter Medical School, Exeter, UK.|Primary Care Unit, Cambridge Centre for Health Services Research, Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, UK.
authors.forename: Gary A
authors.identifier: 0000-0003-2231-5161
authors.initials: GA
authors.lastname: Abel
authors.affiliation: Primary Care Unit, Cambridge Centre for Health Services Research, Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, UK.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Barclay
authors.affiliation: Primary Care Unit, Cambridge Centre for Health Services Research, Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, UK.|Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Rupert A
authors.initials: RA
authors.lastname: Payne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D064890:Social Determinants of Health; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: EPIDEMIOLOGY; Indices of multiple deprivation; STATISTICS & RESEARCH METHODS; social determinants of health