Format du dépôt |
Fichier |
Type de dépôt |
Article dans une revue |
Titre |
en
Ability of ecological deprivation indices to measure social inequalities in a French cohort
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Résumé |
en
Background
Despite the increasing interest in place effect to explain health inequalities, there is currently no consensus on which kind of area-based socioeconomic measures researchers should use to assess neighborhood socioeconomic position (SEP). The study aimed to evaluate the reliability of different area-based deprivation indices (DIs) in capturing socioeconomic residential conditions of French elderly women cohort.
Methods
We assessed area-based SEP using 3 DIs: Townsend Index, French European Deprivation Index (FEDI) and French Deprivation index (FDep), among women from E3N (Etude épidémiologique auprès des femmes de la Mutuelle Générale de l’Education Nationale). DIs were derived from the 2009 French census at IRIS level (smallest geographical units in France). Educational level was used to evaluate individual-SEP. To evaluate external validity of the 3 DIs, associations between two well-established socially patterned outcomes among French elderly women (smoking and overweight) and SEP, were compared. Odd ratios were computed with generalized estimating equations to control for clustering effects from participants within the same IRIS.
Results
The analysis was performed among 63,888 women (aged 64, 47% ever smokers and 30% overweight). Substantial agreement was observed between the two French DIs (Kappa coefficient = 0.61) and between Townsend and FEDI (0.74) and fair agreement between Townsend and FDep (0.21). As expected among French elderly women, those with lower educational level were significantly less prone to be ever smoker (Low vs. High; OR [95% CI] = 0.43 [0.40–0.46]) and more prone to being overweight (1.89 [1.77–2.01]) than women higher educated. FDep showed expected associations at area-level for both smoking (most deprived vs. least deprived quintile; 0.77 [0.73–0.81]) and overweight (1.52 [1.44–1.62]). For FEDI opposite associations with smoking (1.13 [1.07–1.19]) and expected association with overweight (1.20 [1.13–1.28]) were observed. Townsend showed opposite associations to those expected for both smoking and overweight (1.51 [1.43–1.59]; 0.93 [0.88–0.99], respectively).
Conclusion
FDep seemed reliable to capture socioeconomic residential conditions of the E3N women, more educated in average than general French population. Results varied strongly according to the DI with unexpected results for some of them, which suggested the importance to test external validity before studying social disparities in health in specific populations.
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Auteur(s)
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Sofia Temam
1, 2
, Raphaëlle Varraso
1
, Carole Pornet
3
, Margaux Sanchez
1, 2
, Aurélie Affret
4
, Bénédicte Jacquemin
1, 5, 6
, Françoise Clavel-Chapelon
4
, Grégoire Rey
7
, Stéphane Rican
8
, Nicole Le Moual
1
1
VIMA -
Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique
( 422591 )
- Université de Versailles Saint-Quentin-en-Yvelines
2 avenue de la source de la Bièvre
78180 Montigny-le-Bretonneux
Tél. : 01 70 42 92 51
Centre de Gérontologie
Hôpital Sainte Périne, AP-HP
49, rue Mirabeau
75016 Paris
Tél. : 01 44 96 32 04
- France
-
Université de Versailles Saint-Quentin-en-Yvelines ( 81173 )
;
-
Institut National de la Santé et de la Recherche Médicale U1168 ( 303623 )
2
UP11 -
Université Paris-Sud - Paris 11
( 92966 )
- Bâtiment 300 - 91405 Orsay cedex
- France
3
Agence Régionale de Santé Basse-Normandie - ARS [Caen]
( 524204 )
- Espace Claude Monet - 2 place Jean Nouzille 14050 Caen cedex 4.
- France
4
CESP -
Centre de recherche en épidémiologie et santé des populations
( 106188 )
- 16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
- France
-
Université de Versailles Saint-Quentin-en-Yvelines UMR U1018 ( 81173 )
;
-
Université Paris-Sud - Paris 11 ( 92966 )
;
-
Assistance publique - Hôpitaux de Paris (AP-HP) ( 300068 )
;
-
Hôpital Paul Brousse ( 300153 )
;
-
Institut National de la Santé et de la Recherche Médicale U1018 ( 303623 )
5
CREAL -
Center for Research in Environmental Epidemiology
( 74302 )
- Doctor Aiguader, 88 E-08003 Barcelona
- Espagne
-
Universitat Pompeu Fabra [Barcelona] ( 128785 )
;
-
Catalunya ministerio de salud ( 319880 )
6
CIBERESP -
CIBER Epidemiologia y Salud Pùblica [Madrid, Spain]
( 524205 )
- Espagne
-
Instituto de Salud Carlos III [Madrid] ( 308343 )
7
CépiDc -
Centre d'épidémiologie sur les causes médicales de décès
( 172078 )
- 80 rue du Général Leclerc - Secteur Marron/Bâtiment LAFORCE/Porte 58 - 94270 Le Kremlin-Bicêtre Cedex
- France
-
Université Paris Diderot - Paris 7 ( 300301 )
;
-
Institut National de la Santé et de la Recherche Médicale US10 ( 303623 )
8
LADYSS -
Laboratoire Dynamiques Sociales et Recomposition des Espaces
( 1096 )
- Université Paris Ouest Nanterre La Défense Bâtiment T 200 avenue de la République 92001 Nanterre cedex
- France
-
Université Paris 1 Panthéon-Sorbonne UMR7533 ( 7550 )
;
-
Université Paris 8 Vincennes-Saint-Denis UMR7533 ( 11141 )
;
-
Université Paris Nanterre UMR7533 ( 116205 )
;
-
Université Paris Diderot - Paris 7 UMR7533 ( 300301 )
;
-
Centre National de la Recherche Scientifique UMR7533 ( 441569 )
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Volume |
17
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Langue du document |
Anglais
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Numéro |
1
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Page/Identifiant |
956
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Nom de la revue |
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Vulgarisation |
Non
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Comité de lecture |
Oui
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Audience |
Internationale
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Date de publication |
2017
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Date de publication électronique |
2017-12-15
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Domaine(s) |
-
Sciences du Vivant [q-bio]
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Financement |
-
This work was supported by a grant of The Institut pour la Recherche en Santé Publique (IRESP), and of the joint help of Direction Générale de la Santé (DGS), Mission recherche de la Direction de la recherche, des études, de l’évaluation et des statistiques (Mire-DREES), Caisse nationale d’assurance maladie des travailleurs salariés (CNAMTS), Régime Social des Indépendants (RSI) & Caisse nationale de solidarité pour l’autonomie (CNSA). This work was supported in part by the French Agency for Food, Environmental and Occupational Health & Safety in the framework of the SESAP project [grant number: PNR-EST-12-166]. The E3N study is supported by the Mutuelle Générale de l’Education Nationale (MGEN), the French League against Cancer (LNCC), the Gustave Roussy Institute (IGR) and the National Institute for Health and Medical Research (Inserm). Sofia Temam benefited from a PhD scholarship of the Université of Paris-Sud, France.
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Mots-clés |
en
Social inequalities, Deprivation index, Socioeconomic factors
|
DOI |
10.1186/s12889-017-4967-3 |