Skip to main content

Advertisement

Log in

The Development of a Standardized Neighborhood Deprivation Index

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Census data are widely used for assessing neighborhood socioeconomic context. Research using census data has been inconsistent in variable choice and usually limited to single geographic areas. This paper seeks to a) outline a process for developing a neighborhood deprivation index using principal components analysis and b) demonstrate an example of its utility for identifying contextual variables that are associated with perinatal health outcomes across diverse geographic areas. Year 2000 U.S. Census and vital records birth data (1998–2001) were merged at the census tract level for 19 cities (located in three states) and five suburban counties (located in three states), which were used to create eight study areas within four states. Census variables representing five socio-demographic domains previously associated with health outcomes, including income/poverty, education, employment, housing, and occupation, were empirically summarized using principal components analysis. The resulting first principal component, hereafter referred to as neighborhood deprivation, accounted for 51 to 73% of the total variability across eight study areas. Component loadings were consistent both within and across study areas (0.2–0.4), suggesting that each variable contributes approximately equally to “deprivation” across diverse geographies. The deprivation index was associated with the unadjusted prevalence of preterm birth and low birth weight for white non-Hispanic and to a lesser extent for black non-Hispanic women across the eight sites. The high correlations between census variables, the inherent multidimensionality of constructs like neighborhood deprivation, and the observed associations with birth outcomes suggest the utility of using a deprivation, index for research into neighborhood effects on adverse birth outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1

Similar content being viewed by others

Notes

  1. Education included percent males and females with less than a high school education. Employment variables include percent males and females unemployed and percent males no longer in work force. Housing variables include percent rented, percent vacant, percent crowded, percent renter or owner costs in excess of 50% of income, and median household value. Occupation variables include: percent males in management, percent males in professional occupations, percent females in management, and percent females in professional occupations. Poverty variables include percent households in poverty, percent female headed households with dependent children, percent households earning under $30,000 per year, percent households on public assistance, and percent households with no car. Racial composition was estimated using percent residents who were non-Hispanic blacks. Residential stability variables include percent in same residence since 1995 and percent residents 65 years and above.

  2. For FA, a moderate correlation (0.50) represents the minimum loading thought to denote one factor. For PCA, no minimum-loading recommendations are established because the amount of variance explained and subsequent component loading will differ based on the number of variables included in the PCA and the magnitude of error variance.

  3. Three of the 64 (0.05) possible lower 95% confidence limits failed to meet this 0.16 criteria for inclusion.

References

  1. Sampson RJ, Morenoff JD, Gannon-Rowley T. Assessing “neighborhood effects”: social processes and new directions in research. Annu Rev Sociology. 2002;28:443–478.

    Article  Google Scholar 

  2. Wilson W. The Truly Disadvantaged: the Inner City, the Underclass, and Public Policy. Chicago: Chicago University Press; 1987.

    Google Scholar 

  3. Welte J, Wierczorek W, Barnes G, Tidwell M, Hoffman J. The relationship of ecological and geographic factors to gambling. J Gambl Stud. 2004;20(4):405–423.

    Article  PubMed  Google Scholar 

  4. Finch B, Kolody B, Vega W. Contextual effects of perinatal substance exposure among black and white women in California. Sociol Perspect. 1999;42(2):141–156.

    Google Scholar 

  5. Barry J, Breen N. The importance of place of residence in predicting late-stage diagnosis of breast or cervical cancer. Health Place. 2005;11(1):15–29.

    Article  PubMed  Google Scholar 

  6. Klassen A, Curriero F, Hong J, et al. The role of area-level influences on prostate cancer grade and stage at diagnosis. Prev Med. 2004;39(3):441–448.

    Article  PubMed  Google Scholar 

  7. Shenassa E, Stubbendick A, Brown M. Social disparities in housing and related pediatric injury: a multilevel study. Am J Public Health. 2004;94(4):633–639.

    PubMed  Google Scholar 

  8. Cunradi C, Caetano R, Clark C, Schafer J. Neighborhood poverty as a predictor of intimate partner violence among white, black and Hispanic couples in the United States: a multilevel analysis. Ann Epidemiol. 2000;10(5):297–308.

    Article  PubMed  CAS  Google Scholar 

  9. Grisso J, Schwarz D, Hirschinger N, et al. Violent injuries among women in an urban area. N Engl J Med. 1999;341(25):1899–1905.

    Article  PubMed  CAS  Google Scholar 

  10. Diez Roux AV, Merkin SS, Arnett D, et al. Neighborhood of residence and incidence of coronary heart disease. N Engl J Med. 2001;345(2):99–106.

    Article  PubMed  CAS  Google Scholar 

  11. Haan M, Kaplan G, Camacho C. Poverty and health: prospective evidence from the Alameda County study. Am J Epidemiol. 1987;125:989–998.

    PubMed  CAS  Google Scholar 

  12. James S. Primordial prevention of cardiovascular disease among African Americans: a social epidemiological perspective. Prev Med. 1999;29(Supplemental):S84–S89.

    Article  PubMed  CAS  Google Scholar 

  13. Pickett K, Pearl M. Multilevel analysis of neighborhood economic context and health outcomes: a critical review. J Epidemiol Community Health. 2001;55(2):111–122.

    Article  PubMed  CAS  Google Scholar 

  14. Zierler S, Krieger N, Tang Y, et al. Economic deprivation and AIDS incidence in Massachusetts. Am J Public Health. 2000;90(7):1064–1073.

    PubMed  CAS  Google Scholar 

  15. Yost K, Perkins C, Cohen R, Morris C, Wright W. Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control. 2001;12(8):703–711.

    Article  PubMed  CAS  Google Scholar 

  16. Gjelsvik A, Zierler S, Blume J. Homicide risk across race and class: a small area analysis in Massachusetts and Rhode Island. J Urban Health. 2004;81(4):702–718.

    PubMed  Google Scholar 

  17. Robbins J, Webb D. Neighborhood poverty mortality rates, and excess deaths among African Americans: Philadelphia 1999–2001. Journal of Health Care for the Poor and Underserved. 2004;15(4):530–537.

    PubMed  Google Scholar 

  18. Kogan M. Social causes of low birth weight. J R Soc Med. 1995;88:611–615.

    PubMed  CAS  Google Scholar 

  19. Kramer M. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65:663–737.

    PubMed  CAS  Google Scholar 

  20. Parker J, Schoendorf K, Kiely J. Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United States. Ann Epidemiol. 1994;4:271–278.

    Article  PubMed  CAS  Google Scholar 

  21. Wilcox M, Smith S, Johnson I, Maynard P, Chilvers C. The effect of social deprivation on birthweight, excluding physiological and pathological effects. Br J Obstet Gynaecol. 1995;102:918–924.

    PubMed  CAS  Google Scholar 

  22. Roberts EM. Neighborhood social environments and the distribution of low birthweight in Chicago. Am J Public Health. 1997;87(4):597–603.

    PubMed  CAS  Google Scholar 

  23. Rauh V, Andrews H, Garfinkel R. The contribution of maternal age to racial disparities in birthweight: a multilevel perspective. Am J Public Health. 2001;91:1808–1814.

    Google Scholar 

  24. Pearl M, Braveman P, Abrams B. The relationship of neighborhood socioeconomic characteristics to birthweight among 5 ethnic groups in California. Am J Public Health. 2001;91:1808–1814.

    PubMed  CAS  Google Scholar 

  25. O’Campo P, Xue S, Wang M-C, Caughy MOB. Neighborhood risk factors for low birth weight in Baltimore: a multilevel analysis. Am J Public Health. 1997;87(7):1113–1118.

    PubMed  CAS  Google Scholar 

  26. Rajaratnam J, Burke J, O’Campo P. Maternal and child health and neighborhood context: the selection and construction of area-level variables. Health Place. 2005;September 26 e-publication.

  27. Eibner C, Sturm R. U.S.-based indices of area-level deprivation: results from Health Care for Communities. Soc Sci Med. 2006;62:348–359.

    Article  PubMed  Google Scholar 

  28. Liberatos P, Link BG, Kelsey JL. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121.

    PubMed  CAS  Google Scholar 

  29. Townsend P, Phillimore P, Beattie A. Health and Deprivation: Inequality and the North. London: Croom Helm; 1988.

    Google Scholar 

  30. Wright C, Parker L. Forty years on: the effect of deprivation on growth in two Newcastle birth cohorts. Int J Epidemiol. 2004;33(1):147–152.

    Article  PubMed  Google Scholar 

  31. Carstairs V, Morris R. Deprivation, mortality and resource allocation. Community Med. 1989;11:364–372.

    PubMed  CAS  Google Scholar 

  32. Carstairs V, Morris R. Deprivation and Health in Scotland. Aberdeen: Aberdeen University Press; 1991.

    Google Scholar 

  33. Dolk H, Pattendon S, Johnson A. Cerebral palsy, low birthweight and socio-economic deprivation: inequalities in a major cause of childhood disability. Paediatr Perinat Epidemiol. 2001;15(4):359–363.

    Article  PubMed  CAS  Google Scholar 

  34. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: Final Data for 2002: Centers for Disease Control and Prevention; December 17, 2003. National Vital Statistics Reports.

  35. U.S. Census Bureau. Census 2000 Summary File 1 Technical Documentation: Appendix A. Census 2000 Geographic Terms and Concepts [online webpage]. Available at: http://www. census.gov/prod/cen2000/doc/sf1.pdf. Accessed May 1, 2004.

  36. Diez Roux AV. Investigating neighborhood and area effects on health. Am J Public Health. 2001;91(11):1783–1789.

    PubMed  CAS  Google Scholar 

  37. U.S. Census Bureau. Census tracts and block numbering areas. U.S. Census Bureau. November 14, 2000. Available at: http://www.census.gov/geo/www/cen_tract.html. Accessed February 23, 2005.

  38. Juhn Y, Sauver J, Katusic S, Vargas D, Weaver A, Yunginger J. The influence of neighborhood environment on the incidence of childhood asthma: a multilevel approach. Soc Sci Med. 2005;60(11):2453–2464.

    Article  PubMed  Google Scholar 

  39. Pickett K, Collins J, Masi C, Wilkinson R. The effects of racial density and income incongruity on pregnancy outcomes. Soc Sci Med. 2005;60(10):2229–2238.

    PubMed  Google Scholar 

  40. Reagan P, Salsberry P. Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context. Soc Sci Med. 2005;60(10):2217–2228.

    PubMed  Google Scholar 

  41. Ekwo E, Moawad A. Maternal age and preterm births in a black population. Paediatr Perinat Epidemiol. 2000;14(2):145–151.

    Article  PubMed  CAS  Google Scholar 

  42. Krieger N, Chen J, Waterman P, Soobader M-J, Subramanian S, Carson R. Choosing area based socioeconomic measures to monitor social inequalities in low birth weight and childhood lead poisoning: the public health disparities geocoding project (U.S.). J Epidemiol Community Health. 2003;57:186–199.

    Article  PubMed  CAS  Google Scholar 

  43. Singh GK. Area deprivation and widening inequalities in U.S. mortality, 1969–1998. Am J Public Health. 2003;93(7):1137–1143.

    PubMed  Google Scholar 

  44. Berkman L, Macintyre S. The measurement of social class in health studies: old measures and new formulations. In: Kogevinas M, Pearce N, Susser M, Bofetta P, eds. Social Inequalities in Cancer. Lyon, France: International Agency for Research on Cancer; 1997:51–64.

    Google Scholar 

  45. Krieger N, Williams D, Moss N. Measuring social class in U.S. public health research: concepts, methodologies and guidelines. Annu Rev Public Health. 1997;18:341–378.

    Article  PubMed  CAS  Google Scholar 

  46. Link B, Phelan J. Understanding sociodemographic differences in health: the role of fundamental social causes. Am J Public Health. 1996;86:471–473.

    PubMed  CAS  Google Scholar 

  47. Margai F, Henry N. A community-based assessment of learning disabilities using environmental and contextual risk factors. Soc Sci Med. 2003;56(5):1073–1085.

    Article  PubMed  Google Scholar 

  48. Huang S, Finkelstein J, Rifas-Shiman S, Kleinman K, Platt R. Community-level predictors of pneumococcal carriage and resistance in young children. Am J Epidemiol. 2004;159(7):645–654.

    Article  PubMed  Google Scholar 

  49. Ainsworth J. Why does it take a village? The mediation of neighborhood effects on educational achievement. Soc Forces. 2002;81:117–152.

    Google Scholar 

  50. Browning CR, Wallace D, Feinberg SL, Cagney KA. Neighborhood social processes and disaster-related mortality: the case of the 1995 Chicago heat wave. Paper presented at: Population Association of America, 2004; Boston, Massachusetts.

  51. Franzini L, Spears W. Contributions of social context to inequalities in years of life lost to heart disease in Texas, USA. Soc Sci Med. 2003;57(10):1847–1861.

    Article  PubMed  Google Scholar 

  52. Cubbin C, LeClere F, Smith G. Socioeconomic status and injury mortality: individual and neighbourhood determinants. J Epidemiol Community Health. 2000;54:517–524.

    Article  PubMed  CAS  Google Scholar 

  53. Coulton C, Korbin J, Su M, Chow J. Community level factors and child maltreatment rates. Child Dev. 1995;66(5):1262–1276.

    Article  PubMed  CAS  Google Scholar 

  54. Sampson R, Morenoff J, Earls F. Beyond social capital: spatial dynamics of collective efficacy for children. Am Sociol Rev. 1999;64:633–660.

    Article  Google Scholar 

  55. Cagney K, Browning C. Exploring neighborhood-level variation in asthma and other respiratory diseases: the contribution of neighborhood social context. J Intern Med. 2004;19(3):229–236.

    Google Scholar 

  56. Silver E, Mulvey E, Swanson J. Neighborhood structural characteristics and mental disorder: Faris and Dunham revisited. Soc Sci Med. 2002;55:1457–1470.

    Article  PubMed  Google Scholar 

  57. Robert SA. Community-level socioeconomic effects on adult health. J Health Soc Behav. 1998;39:18–37.

    Article  PubMed  CAS  Google Scholar 

  58. McCulloch A. An examination of social capital and social disorganisation in neighbourhoods in the British household panel study. Soc Sci Med. 2003;56(7):1425–1438.

    Article  PubMed  Google Scholar 

  59. Ross CE, Mirowsky J. Neighborhood disadvantage, disorder and health. J Health Soc Behav. 2001;42(September):258–276.

    Article  PubMed  CAS  Google Scholar 

  60. Wang F, Luo W. Assessing spatial and nonspatial factors for healthcare access: towards an integrated approach to defining health professional shortage areas. Health Place. 2005;11(2):131–146.

    Article  PubMed  Google Scholar 

  61. James R, Mustard C. Geographic location of commercial plasma donation clinics in the United States, 1980–1995. Am J Public Health. 2004;94(7):1224–1229.

    Article  PubMed  Google Scholar 

  62. Bell D, Carlson J, Richard A. The social ecology of drug use: a factor analysis of an urban environment. Subst Use Misuse. 1998;33(11):2207–2217.

    Google Scholar 

  63. Stafford M, Cummins S, Macintyre S, Ellaway A, Marmot M. Gender differences in the associations between health and neighbourhood environment. Soc Sci Med. 2005;60:1681–1692.

    Article  PubMed  CAS  Google Scholar 

  64. Mares A, Desai R, Rosenheck R. Association between community and client characteristics and subjective measures of the quality of housing. Psychiatr Serv. 2005;56(3):315–319.

    Article  PubMed  Google Scholar 

  65. Buka SL, Brennan RT, Rich-Edwards JW, Raudenbush SW, Earls F. Neighborhood support and the birth weight of urban infants. Am J Epidemiol. 2003;157(1):1–8.

    Article  PubMed  Google Scholar 

  66. Ewing R, Schmid T, Killingsworth R, Zlot A, Raudenbush S. Relationship between urban sprawl and physical activity, obesity, and morbidity. Am J Health Promot. 2003;18(1):47–57.

    PubMed  Google Scholar 

  67. Martens P, Frohlich N, Carriere K, Derksen S, Brownell M. Embedding child health within a framework of regional health: population health status and sociodemographic indicators. Can J Public Health. 2002;93(Supplement 2):S15–S20.

    PubMed  Google Scholar 

  68. Singh G, Miller B, Hankey B, Feuer E, Pickle L. Changing area sociodemographic patterns in U.S. cancer mortality, 1950–1998. Part I. All cancers among men. J Natl Cancer Inst. 2002;94(12):904–915.

    PubMed  Google Scholar 

  69. Salmond C, Crampton P, Sutton F. NZDep91: a New Zealand index of deprivation. Aust N Z J Public Health. 1998;22(7):835–837.

    PubMed  CAS  Google Scholar 

  70. DeCoster J. Overview of Factor Analysis. Available at: http://www.bama.ua.edu/~pysc/factor.pdf. Accessed March 16, 2005.

  71. Tabachnick BG, Fidell LS. Chapter 13: Principal Components and Factor Analysis. Using Multivariate Statistics, 3rd Edition. Northridge, California: California State University, Harper Collins College; 1996:635–708.

    Google Scholar 

  72. Pohlmann J. Factor analysis glossary. Department of Education Psychology and Special Education. Available at: http://www.siu.edu/~epse1/pohlmann/factglos/. Accessed April 7, 2005.

  73. Kim J-O, Mueller CW. Factor Analysis: Statistical Methods and Practical Issues, Vol 07-014. Newbury Park, California: Sage; 1978.

    Google Scholar 

  74. Alexander GR, Himes JM, Kaufman RB, Mor J, Kogan M. A United States national reference for fetal growth. Obstetr Gynecol. 1996;87(2):163–168.

    Article  CAS  Google Scholar 

  75. Singh G, Siahpush M. Increasing inequalities in all-cause and cardiovascular mortality among U.S. adults aged 25–64 years by area socioeconomic status, 1969–1998. Int J Epidemiol. 2002;31:600–613.

    Article  PubMed  Google Scholar 

  76. Macintyre S, Ellaway A, Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them? Soc Sci Med. 2002;55:125–139.

    Article  PubMed  Google Scholar 

  77. Ahern J, Pickett K, Selvin S, Abrams B. Preterm birth among African American and white women: a multilevel analysis of socioeconomic characteristics and cigarette smoking. J Epidemiol Community Health. 2003;57:606–611.

    Article  PubMed  CAS  Google Scholar 

  78. Pickett KE, Ahern JE, Selvin S, Abrams B. Neighborhood socioeconomic status, maternal race and preterm delivery: a case–control study. Ann Epidemiol. 2002;12:410–418.

    Article  PubMed  Google Scholar 

  79. English PB, Kharrazi M, Davies S, Scalf R, Waller L, Neutra R. Changes in the spatial pattern of low birth weight in a southern California county: the role of individual and neighborhood level factors. Soc Sci Med. 2003;56:2073–2088.

    Article  PubMed  Google Scholar 

  80. Ponce N, Hoggatt K, Wilhelm M, Ritz B. Preterm birth: the interaction of traffic-related air pollution with economic hardship in Los Angeles neighborhoods. Am J Epidemiol. 2005;162:140–148.

    Article  PubMed  Google Scholar 

  81. Kaufman JS, Dole N, Savitz DA, Herring A. Modeling community-level effects on preterm birth. Ann Epidemiol. 2003;13(5):377–384.

    Article  PubMed  Google Scholar 

  82. Krieger N. Women and social class: a methodological study comparing individual, household, and census measures as predictors of black/white differences in reproductive history. J Epidemiol Community Health. 1991;45:35–42.

    PubMed  CAS  Google Scholar 

  83. Morenoff JD. Neighborhood mechanisms and the spatial dynamics of birthweight. Am J Sociol. 2003;108(5):976–1017.

    Article  PubMed  Google Scholar 

  84. Rich-Edwards JW, Buka SL, Brennan RT, Earls F. Diverging associations of maternal age with low birthweight for black and white mothers. Int J Epidemiol. 2003;32:83–90.

    Article  PubMed  Google Scholar 

  85. Jaffee KD, Perloff JD. An ecological analysis of racial differences in low birthweight: implications for maternal and child health social work. Health Soc Work. 2003;28:9–22.

    PubMed  Google Scholar 

  86. Kirby D, Coyle K, Gould J. Manifestations of poverty and birthrates among you teenagers in California zip codes. Fam Plann Perspect. 2001;33:63–69.

    Article  PubMed  CAS  Google Scholar 

  87. Martens P, Derksen S, Gupta S. Predictors of hospital readmission of Manitoba newborns within six weeks of postbirth discharge: a population-based study. Pediatrics. 2004;114:708–713.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Financial and technical support for this study was provided by the NHEERL—DESE Cooperative Training in Environmental Sciences Research, EPA CT 829471 and The Maternal and Child Health Bureau of the Health Resources and Services Administration, U. S. Department of Health and Human Services. Many thanks to Lisa Vinikoor for her work on the project and to Robert DeVellis, who reviewed an earlier version of this manuscript. The authors are indebted to Michael Kogan (MCHB/HRSA), John Park (formerly of MCHB), Mary Kay Kenney (MCHB/HRSA), Paul Buescher (North Carolina State Center for Health Statistics), Violanda Grigorescu (Office of Vital and Health Statistics, Michigan Department of Community Health), Brian Castrucci (Philadelphia Department of Public Health, Division of Maternal, Child, and Family Health) and Isabelle Horon (Vital Statistics Administration, Maryland Department of Health and Mental Hygiene). Jennifer Culhane, Claudia Holzman, Barbara Laraia, and Patricia O’Campo are principal investigators and share equal responsibility for this project.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lynne C. Messer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Messer, L.C., Laraia, B.A., Kaufman, J.S. et al. The Development of a Standardized Neighborhood Deprivation Index. J Urban Health 83, 1041–1062 (2006). https://doi.org/10.1007/s11524-006-9094-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-006-9094-x

Keywords

Navigation