Title | Construction of an area-deprivation index for 2869 counties in China: a census-based approach |
Authors | Wang, Zhicheng Chan, Kit Yee Poon, Adrienne N. Homma, Kirsten Guo, Yan |
Affiliation | Peking Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Beijing, Peoples R China Tsinghua Univ, Vanke Sch Publ Hlth, Beijing, Peoples R China Tsinghua Univ, Sch Med, Res Ctr Publ Hlth, Beijing, Peoples R China Univ Edinburgh, Usher Inst, Ctr Global Hlth, Edinburgh, Midlothian, Scotland Univ Melbourne, Nossal Inst Global Hlth, Melbourne, Vic, Australia George Washington Univ, Dept Med, Sch Med & Hlth Sci, Washington, DC USA Columbia Univ, Dept Med, New York Presbyterian, New York, NY USA |
Keywords | SOCIAL DEPRIVATION INEQUALITIES HEALTH MORTALITY SYSTEM |
Issue Date | Feb-2021 |
Publisher | JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH |
Abstract | Background A paucity of data has made it challenging to construct a deprivation index at the lowest administrative, or county, level in China. An index is required to guide health equity monitoring and resource allocation to regions of greatest need. This study used China's 2010 census data to construct a county-level area-deprivation index (CADI). Methods Data for 2869 counties from China's 2010 census were used to generate a CADI. Eleven indicators across four domains of deprivation were selected for principal component analysis with standardisation of the first principal component. Sensitivity analysis was used to test whether the population size and weighting method affected the index's robustness. Deprived counties identified by the CADI were then compared with China's official list of poverty-stricken counties. Results The first principal component explained 60.38% of the total variation in the deprivation indicators. The CADI ranged from the least deprived value of -2.71 to the most deprived value of 2.92, with SD of 1. The CADI was found to be robust against county-level population size and different weighting methods. When compared with the official list of poverty-stricken counties in China, the deprived counties identified by the CADI were found to be even more deprived. Conclusion Constructing a robust area-deprivation index for China at the county level based on population census data is feasible. The CADI is a potential policy tool to identify China's most deprived areas. In the future, it may support health equity monitoring and comparison at the national and subnational levels. |
URI | http://hdl.handle.net/20.500.11897/622041 |
ISSN | 0143-005X |
DOI | 10.1136/jech-2020-214198 |
Indexed | SCI(E) |
Appears in Collections: | 公共卫生学院 |