Construction and Validation of an Individual Deprivation Index: a Study Based on a Representative Cohort of the Paris Metropolitan Area

Sohela Moussaoui, Pierre Chauvin, Gladys Ibanez, Marion Soler, Virginie Nael, Claire Morgand, Sarah Robert

Keywords: Social determinants of health · Deprivation · Index · France · Living standards · Health inequalities · Validity

Background:

The association between health status and deprivation is well established. However, it is difficult to measure deprivation at an individual level and already-existing indices in France are not validated or do not meet the needs of health practitioners.

Research questions:

The aim of this work was to establish a validated, easy-to-use, multidimensional, relevant index that was representative of the population in the Paris metropolitan area.

Method:

The sample was drawn from the 2010s wave of the SIRS cohort study which is representative of French-speaking adults living in the Paris metropolitan area. A total of 3006 people were included between December 2010 and December 2011 through a multistage cluster sampling procedure. First, 50 census blocks called “IRISs” were randomly selected from the 2595 eligible in the Paris metropolitan area. Then, 60 households were randomly chosen within each selected IRISs and third, one adult was selected within each household . A total of 14 socio-economic characteristics were selected: health insurance, educational background, socio-professional category, professional status, feelings of loneliness, emotional origin. In addition, a total of 12 health status, healthcare use, and nutrition-related variables were also selected. Content validity and internal validity of the index were explored.

Results:

The 14 socio-economic indicators were associated to varying degrees with poorer health status, less use of healthcare, and poorer nutrition and were distributed across the 14 multiple choice questions of the index. Each answer was rated from 0 to 2. The index value of 10 that isolates 20% of the most deprived individuals was used as threshold. “Being deprived,” as defined with this value, was significantly associated with 9 of the 12 studied health variables. The Cronbach’s alpha value was 0.68.

Conclusions:

This index could be a relevant instrument in the assessment of deprivation and social inequalities of health.

Points for discussion:

PRECAR index seems to be a relevant score for the general practice

Strength: met the content and construct validity criteria; fair internal consistency

Limitations: length of the index, needs to be regularly updated