Author
Listed:
- Laura Grisotto
- Dolores Catelan
- Gabriele Accetta
- Annibale Biggeri
Abstract
A relationship between socio-economic status and health has been widely documented both by individual-level and ecological regression studies. We addressed the problem known in the literature as Mutual Standardization using a material deprivation index as predictor of health needs and comparing results when adjusting or not the health outcome and the deprivation index for the same confounding variables. We focus on non-linear hierarchical models. We take as example the the issue of introducing socio-economic indicators in national or regional resources allocation formulas. We fitted a series of models with different data hierarchies to evaluate both the individual effect and the aggregate (census block) effect of material deprivation on heath status, disentagling the individual from the contextual effects. Individual mortality records came from the Florence census cohort 1991-1995 which is part of the Tuscan Longitudinal Study. Data on socio-economic factors derived from individual records of the 1991 census. Our results suggested that after adjusting for age, material deprivation is a good predictor of health needs both at individual and at aggregate level (census block). The presence of a contextual effect increases the interest in using deprivatin in the allocation formula, since it would permit a better distribution of resources to disadvantaged micro-areas. In the present paper, we stress the need to estimate the association between deprivation and health appropriately adjusting for age. The ideal goal would be having information at small geographical level on the joint distribution of age and deprivation, which permits to age-standardize both the response and the predictor. A temporary solution should be to regress crude mortality rates on deprivation and age. The current common practice, in absence of individual data, to regress standardized mortality on material deprivation may be inappropriate.
Suggested Citation
Laura Grisotto & Dolores Catelan & Gabriele Accetta & Annibale Biggeri, 2010.
"Material deprivation as marker of health needs,"
Statistica, Department of Statistics, University of Bologna, vol. 70(3), pages 343-352.
Handle:
RePEc:bot:rivsta:v:70:y:2010:i:3:p:343-352
Download full text from publisher
To our knowledge, this item is not available for
download. To find whether it is available, there are three
options:
1. Check below whether another version of this item is available online.
2. Check on the provider's
web page
whether it is in fact available.
3. Perform a
search for a similarly titled item that would be
available.
Corrections
All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bot:rivsta:v:70:y:2010:i:3:p:343-352. See general information about how to correct material in RePEc.
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
We have no bibliographic references for this item. You can help adding them by using this form .
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Giovanna Galatà (email available below). General contact details of provider: https://edirc.repec.org/data/dsbolit.html .
Please note that corrections may take a couple of weeks to filter through
the various RePEc services.