The geographic relationship between sexual health deprivation and the Index of Multiple Deprivation 2010: a comparison of two indicesZheng Yin A E , Stefano Conti B , Sarika Desai A , Mai Stafford C , Wendi Slater D , O. Noel Gill A and Ian Simms A
A HIV & STI Department, Health Protection Services, Colindale, Health Protection Agency, London NW9 5EQ, UK.
B Statistics Unit, Health Protection Services, Colindale, Health Protection Agency, London NW9 5EQ, UK.
C Medical Research Council Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, UK.
D South West Public Health Observatory, Grosvenor House, 149 Whiteladies Road, Clifton, Bristol BS8 2RA, UK.
E Corresponding author. Email: firstname.lastname@example.org
Sexual Health 10(2) 102-111 https://doi.org/10.1071/SH12057
Submitted: 26 April 2012 Accepted: 1 September 2012 Published: 1 March 2013
Objectives: To construct an Index of Sexual Health Deprivation (ISHD), examine its sensitivity, investigate the association between the ISHD and the Index of Multiple Deprivation 2010 (IMD2010), and interpret the observed geographic variation. Methods: The modified IMD method was informed by the IMD2010. Thirteen profiles relating to sexual health were selected and grouped into four domains. The observed profile values for each primary care trust (PCT) were smoothed and converted to a normal distribution before principal component analysis. Loadings were used to calculate profile weights. Domain scores were calculated by combining weighted profiles, which were combined to create the ISHD. A Bayesian approach acted as a comparator for the ISHD. Results: Substantial variation in sexual health deprivation was seen across strategic health authorities (SHA). The London SHA had the highest proportion of PCTs (61%) among the most deprived quartile, followed by North-West SHA (29%). More than half of PCTs in East of England (71%), South Central (56%) and South-West (50%) SHAs fell into the least deprived quartile. No PCTs within the East of England, South Central and South-West SHAs were in the most deprived quartile. Only 57% of PCTs were attributed to the same quartile of the ISHD as the IMD2010. The modified IMD method and the Bayesian approach produced consistent results. Conclusions: The ISHD provides a robust picture of the geography of sexual health and shows a weak association with the IMD2010. It can be used to guide public health action to reduce the geographical gradient in sexual health inequality.
Additional keywords: England, geographic variation, HIV, inequality, multi-dimensional index, sexually transmissible infection, teenage pregnancy.
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