A newly developed deprivation index, life expectancy and cancer incidence in the Czech Republic

Background

In the absence of individual-level data on socioeconomic status, small area-based indices of deprivation are valuable tools to detect and monitor social inequalities, a notable example being the Index of Multiple Deprivation (IMD) in England. While there are several versions of IMD in Western Europe, we are not aware of any such index with sufficient resolution in Central and Eastern Europe (CEE). We developed a new IMD in the Czech Republic and tested the associations of the working version of the index with life expectancy and with incidence of several types of cancer.

Methods

We adapted the general methodology of the English IMD and used administrative data on 18 sub-indicators across 6 deprivation domains (housing and services, crime, education, employment, living environment, and income). We calculated IMD for custom clusters of micro-spatial administrative zones (∼3,000 small areas equivalent to LSOA). Municipal-level life expectancy and cancer incidence data were disaggregated into LSOAs using age- and sex-standardized expected risk weights.

Results

The new IMD revealed significant spatial disparities with structural concentration of high deprivation in the peripheries of the county. There was a 3-year gap in life expectancy between the least and most deprived deciles of IMD, accounting for 150,000 years of life lost annually. For cancer incidence, the models show consistent social gradients. Compared with the most deprived decile, the risk in residents in the least deprived decile were at 10% lower for colorectal cancer, 25% lower for pancreatic cancer and 18% lower for lung cancer.

Conclusions

These findings are consistent with previous individual level studies and confirm the utility of the newly developed IMD in capturing and monitoring the link between health and deprivation. Existing administrative data should be sufficient to construct similar deprivation indices in other countries of CEE.

Key messages

• The new routine data-based deprivation index captures well special disparities in health.

• Existing administrative data should allow construction of similar indices in other countries of CEE.