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Development of a cross-cultural deprivation index in five European countries
  1. Elodie Guillaume1,
  2. Carole Pornet1,2,
  3. Olivier Dejardin1,2,
  4. Ludivine Launay1,3,
  5. Roberto Lillini4,5,
  6. Marina Vercelli5,
  7. Marc Marí-Dell'Olmo6,7,8,
  8. Amanda Fernández Fontelo7,
  9. Carme Borrell6,7,8,9,
  10. Ana Isabel Ribeiro10,
  11. Maria Fatima de Pina10,
  12. Alexandra Mayer11,
  13. Cyrille Delpierre12,13,
  14. Bernard Rachet14,
  15. Guy Launoy1,2
  1. 1French Institute of Health and Medical Research—Caen University, U1086 “Cancers & Préventions”, Caen, France
  2. 2Pôle Recherche, University Hospital of Caen, Caen, France
  3. 3Centre François Baclesse, Avenue du Général Harris—BP5026, Caen, France
  4. 4Department of Sociology, PhD School in Applied Sociology and Methodology of Research, University of Milan-Bicocca, Genoa, Italy
  5. 5Department of Health Sciences, University of Genoa, Genoa, Italy
  6. 6CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  7. 7Agència de Salut Pública de Barcelona, Barcelona, Spain
  8. 8Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
  9. 9Universitat Pompeu Fabra, Barcelona, Spain
  10. 10Instituto de Engenharia Biomédica—INEB, Universidade do Porto—Departamento de Epidemiologia Clínica, Medicina Preditiva e Saúde Pública, Faculdade de Medicina do Porto, Universidade do Porto—Instituto de Saúde Pública da Universidade do Porto—ISPUP, Porto, Portugal
  11. 11Registro Oncologico Regional Sul, Lisbon, Portugal
  12. 12INSERM, U1027, Toulouse F-31300, Toulouse, France
  13. 13Université Toulouse III Paul-Sabatier, UMR1027, Toulouse F-31300, Toulouse, France
  14. 14Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Elodie Guillaume, “Cancers & Préventions,” U1086 INSERM-UCBN, Pôle Recherche CHU CAEN, Centre François Baclesse, Avenue du Général Harris, BP 5026, Caen Cedex 05 14076, France; elodie.guillaume{at}


Background Despite a concerted policy effort in Europe, social inequalities in health are a persistent problem. Developing a standardised measure of socioeconomic level across Europe will improve the understanding of the underlying mechanisms and causes of inequalities. This will facilitate developing, implementing and assessing new and more effective policies, and will improve the comparability and reproducibility of health inequality studies among countries. This paper presents the extension of the European Deprivation Index (EDI), a standardised measure first developed in France, to four other European countries—Italy, Portugal, Spain and England, using available 2001 and 1999 national census data.

Methods and results The method previously tested and validated to construct the French EDI was used: first, an individual indicator for relative deprivation was constructed, defined by the minimal number of unmet fundamental needs associated with both objective (income) poverty and subjective poverty. Second, variables available at both individual (European survey) and aggregate (census) levels were identified. Third, an ecological deprivation index was constructed by selecting the set of weighted variables from the second step that best correlated with the individual deprivation indicator.

Conclusions For each country, the EDI is a weighted combination of aggregated variables from the national census that are most highly correlated with a country-specific individual deprivation indicator. This tool will improve both the historical and international comparability of studies, our understanding of the mechanisms underlying social inequalities in health and implementation of intervention to tackle social inequalities in health.

  • Health inequalities
  • Measurement tool Development

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