Russian subject-level index of multidimensional deprivation and its association with all-cause and infant mortality.

Abstract

Background: Social and environmental inequalities in public health are recognized as global problems of our time. From the point of view of the theory of deprivation, social and environmental determinants identified as deprivation indicators, which help to detect health inequality. Indices are one of the most practical and powerful tools for measuring the level of deprivation.

Objectives: The aims of our study are (1) to develop a Russian derivation index to measure the levels of deprivation and (2) to analyze its associations with total and infant mortality.

Material and methods: Deprivation indicators were obtained from the Federal State Statistics Service of Russia. All mortality data were taken from the official website of the Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation from 2009 to 2012. Principal components analysis with varimax rotation was used to (1) select suitable deprivation indicators and (2) create the index. A Spearman's correlation was run to determine the relationship of deprivation with all-cause and infant mortality. Ordinary least squares (OLS) regression was used to assess the relationship between deprivation and infant mortality. Development of the index and statistical analysis were carried out using R and SPSS software.

Results: There is not a statistically significant correlation between deprivation and all-cause mortality. OLS regression showed a significant relationship between deprivation and infant mortality (p = 0.02). For every one-unit increase in the index score, infant mortality rate increases by about 20%.