Scottish Indices of Multiple Deprivation (SIMD) The dataset for the Lothian NHS Board Public Health Annual Report 2004 uses the Scottish Indices of Multiple Deprivation (SIMD). These indices are the most recent method of examining different aspects of deprivation in small geographical areas. They were published in 2003 by the Social Disadvantage Research Centre and are based on 1999 electoral ward geography. These indices are a considerable improvement on previous geographical measures of deprivation such as the Carstairs 1991 deprivation scores. The 2003 SIMD are the first Scottish measure of this type and follow similar deprivation indices developed for England, Wales and Northern Ireland. In order to understand the rationale behind the deprivation indices it is important to understand what is meant by deprivation. In the article Deprivation, Townsend writes that people can be said to be deprived if they lack the types of diet, health, clothing, housing, household facilities and fuel and environmental, educational, working and social conditions, activities and facilities which are customary, or at least widely encouraged and approved, in the societies to which they belong. (Townsend, 1987) Townsend raises the notion of different aspects of deprivation and, of multiple deprivation, whereby individuals experience deprivation of more than one kind. The indices measure deprivation in five different Domains. These are: Income, Employment, Education Skills and Training, Geographical Access to Services and Health. Each of the five domains examines a different aspect of deprivation and are composed from a collection of indicators. Local authority and ward area boundaries are based on those in place in 1999, while indicators as far was possible, were measured in 2001. A full breakdown of the domains and indicators can be found in Table 1. There are 1222 electoral wards in Scotland. Each ward can be ranked according to their score for each domain. This allows identification of wards where people are experiencing a particular type of deprivation (e.g. Income or Education). For example, an Income rank of 1222 would make a ward the least Income deprived in Scotland. Conversely, an Education Skills and Training rank of 1 would make that the most deprived ward in Scotland for that domain. Each ward also has an overall rank and composite score for the five domains together. Figure 1 shows the weighting of each of the different domains in making this composite score. This process can be examined in greater depth in the complete report on the SIMD (Scottish Executive, 2003), which can be accessed here.
The SIMD 2003 form the basis of a long-term Scottish Executive strategy for an area-based measure of deprivation in Scotland and further domains and indicators will be added in the future. There is also a move toward a smaller geographical base for the indices that will better represent natural communities and help highlight pockets of deprivation not apparent from ward level analysis. Figure 1 Domain weighting of Scottish Indices of Multiple Deprivation Health & Disability 15% Employment 30% Education, Skills & Training 15% Income 30% Geographical Access to Services 10% Application of SIMD for this dataset Only the Lothian wards are considered in this dataset. Each ward has been ranked at a Lothian and at Local Healthcare Cooperative (LHCC) level for each domain. The Income, Employment, Education Skills and Training, and Geographical Access to services domains were considered in relation to the indicators of health inequalities presented in Improving Health in Scotland The Challenge (Scottish Executive, 2003a). As the focus of this dataset is health and deprivation the SIMD health domain was excluded from our dataset because there would be no benefit to comparing wards already ranked by health deprivation against further measures of health. A complete list of the health indicators used in this dataset, how they were measured and associated caveats can be found in Table 2.
Table 1: SIMD Domains and Domains and Source Income Deprivation (SIMD weighting=30%) (Summed to give score) Adults in Income Support households (DWP, April 2001) Children in Income Support households (DWP, April 2001) Adults in Income Based Job Seekers Allowance households (DWP, April 2001) Children in Income Based Job Seekers Allowance (DWP, April 2001) households Children in Working Families Tax Credit households below a (DWP, April 2001) low income threshold Adults in Disability Tax Credit households below a low income (DWP, April 2001) threshold Adults in Working Families Tax Credit households below a (DWP, April 2001) low income threshold Children in Disability Tax Credit households below a low (DWP, April 2001) income threshold Employment Deprivation (SIMD weighting = 30%) (Summed to give score) Unemployment claimant count of those aged under 60 (ONS, April 2001) Incapacity Benefit recipients aged under 60 (DWP, April 2001) Severe Disablement Allowance recipients aged under 60 (DWP, April 2001) Compulsory New Deal participants - New Deal for the under (DWP, April 2001) 25s and New Deal for 25 + not included in the unemployment claimant count Health Deprivation & Disability (SIMD weighting=15%) Weighting Comparative Mortality Factor (CMFs) for under 75's (ISD, 1997-2001) 13% Hospital episodes related to alcohol use (ISD, 1997-2001) 12% Hospital episodes related to drug use (ISD, 1997-2001) 11% Comparative Illness Factor (DWP, 2001) 39% Emergency admissions to hospital (ISD, 1997-2001) 10% Proportion of population being prescribed drugs for anxiety or (ISD, 2001) 8% depression or psychosis Proportion of live singleton births of low birth weight (<2,500g) (ISD, 1997-2001) 7% Education Skills & Training (SIMD weighting=15%) Working age adults (25-59) with no qualifications (LFS, 1996-2000) 13% Pupils aged 16+ who are not in full time education (DWP, 2001) * 16% Proportions of the 17+ population who have not successfully applied to Higher Education (UCAS, 1999-2001)* Pupil performance on SQA at Stage 4 (SQA, 2001) 65% Secondary level absences (SE 2000/1) 6% * These two indicators were combined Geographical access to services (SIMD weighting=10%) Road distance to a GP surgery or health centre (ISD, 2002) 19% Road distance to a general stores or supermarket (MS, 2002) 25% Road distance to a primary school (SE, 2001) 12% Road distance to a petrol station (RL & MS, 2002) 11% Road distance to a bank or building society (RL & MS, 2002) 18% Road distance to community internet facilities (SE, 2001) 15%
Table 1 Key: DWP = Department of Work & Pensions LFS = Labour Force Survey RL & MS = Retail Location & Market Scan ONS = Office for National Statistics MS = Market Scan SE = Scottish Executive UCAS = University & Colleges Admissions Service Table 2: of health inequalities Health Indicator Source 1 Descriptor Caveats / Additional Smoking at health Percentage of mothers Smoking/Nonvisitor first visit Smoking at Health visitors first visit. Childhood emergency admissions Breastfeeding at 6-8 weeks Teenage pregnancies (females aged 13-19) CHD mortality under 75 years Cancer mortality under 75 years Life expectancy at birth Child Health Surveillance Programme (CHSP) SMR01 Child Health Surveillance Programme (CHSP) SMR01, SMR02 GRO Standardised discharge rates for any emergency admission, for children under 15 years. CHSP records whether a child is fed with breast milk, formula or a mixture of both at the 6-8 week review. Crude rates, per 1000 women, teenage pregnancies for females aged 13-19 years Average annual rate of Coronary Heart Disease deaths (1998-2002), for males and females under 75 years of age. GRO Average annual rate of Cancer deaths (1998-2002), for males and females under 75 years of age. GRO, SNS GRO, SAPEEL Life expectancy at birth by LHCC. Populations taken from Scottish Neighbourhood Statistics. Life expectancy calculated using the Chiang method (II). Life expectancy at birth by SIMD quintile. Lothian wards are split into five groups depending on overall Lothian rank from composite score of all domains. Population taken from Small area population estimates for Edinburgh & Lothians (SAPEEL) 2000. Life expectancy calculated using the Chiang method (II). 1 Populations used for analysis were taken from Scottish Neighbourhood Statistics (SNS) website unless specified otherwise. Graphs show percentage of Non-smoking mothers as the percentage of Smoking mothers was equal to zero in many cases. Rates per 100,000. Confidence Intervals available on request A proportion of these records were coded incorrectly and have been classified as invalid As only crude rates are used, comparisons should not be made between wards. As only crude rates are used, comparisons should not be made between wards. Uses full postcodes to match deaths to wards Uses postcode sectors to match deaths to LHCCs
Bibliography Bailey NJ, Flint R, Goodland M, Shucksmith S, Fitzpatrick G and Pryce G (2003) Measuring Deprivation In Scotland: Developing A Long-Term Strategy Edinburgh, Scottish Executive Central Statistics Unit Noble M, Wright G, Lloyd M, Dibben C, Smith G, Ratcliffe A, McLennan D, Siagala M, Anttila C. (2003) The Scottish Indices of Deprivation 2003 Edinburgh, Scottish Executive Scottish Executive (2003) Measuring Deprivation in Scotland: Scottish Executive Response Edinburgh, Scottish Executive Scottish Executive (2003a) Improving Health The Challenge Edinburgh, Scottish Executive Townsend P (1987) Deprivation Journal of Social Policy 16 (1):126